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Myocardial ischemia, ventricular arrhythmias and implantable cardioverter-defibrillators: Importance of stored electrograms

  • Chapter
Myocardial Ischemia and Arrhythmia

Summary

The Ventak P2 defibrillator can store electrograms sensed via the shocking leads prior to the onset of an episode as well as immediately before and after each therapy delivery. A total of 65 stored electrograms were retrieved and evaluated in 23 patients in order to differentiate between appropriate, inappropriate and abortive shock delivery. During follow-up of 10 ± 6 months, 20 appropriate shocks occurred during 14 spontaneous episodes of ventricular tachyarrhythmias in 5 patients. Inappropriate shocks were delivered as follows: 21 shocks during 13 episodes of atrial tachyarrhythmias with rapid ventricular response in 5 patients, 9 shocks during 3 episodes of sinus tachycardia in 2 patients and 1 shock due to oversensing during normal sinus rhythm in 1 patient. Abortive shocks were documented as follows: 6 episodes of nonsustained ventricular tachycardia in 3 patients, 27 episodes of atrial fibrillation in 7 patients and exercise induced sinus tachycardia in 1 patient. After reprogramming the device and/or changing the current antiarrhythmic drug therapy, no subsequent inappropriate or abortive shock therapy was noted. In conclusion, appropriate shocks occurred in 14 of 65 episodes (21.5%) and in 5 of 23 patients (21.7%). Inappropriate shock delivery is not a rare finding and was documented in 16 of 65 (24.6%) and in 7 of 23 patients (30.4%). Unnecessary shock delivery could be prevented by reconfirmation of the arrhythmia during capacitor charging in 35 of 65 episodes (53.8%) and in 11 of 23 patients (47.8%). Stored electrograms allowed to clearly differentiate between appropriate, inappropriate, and abortive shock discharges.

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Author information

Authors and Affiliations

  1. Department of Cardiology, University of Bonn, Bonn, Germany

    M. Manz & B. Lüderitz

  2. Department of Cardiology, University of Bonn, Sigmund-Freud-Straße 25, Bonn, D-53105, Germany

    W. Jung MD

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  1. W. Jung MD
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  2. M. Manz
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  3. B. Lüderitz
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Editor information

Editors and Affiliations

  1. Abt. Innere Medizin III, Medizinische Universitätsklinik, Hugstetter Straße 55, 79106, Freiburg, Germany

    M. Zehender  & H. Just  & 

  2. Innere Medizin, Universitätskrankenhaus Eppendorf, Martinistraße 52, 20246, Hamburg, Germany

    T. Meinertz

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© 1994 Dr. Dietrich Steinkopff Verlag GmbH & Co. KG, Darmstadt

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Jung, W., Manz, M., Lüderitz, B. (1994). Myocardial ischemia, ventricular arrhythmias and implantable cardioverter-defibrillators: Importance of stored electrograms. In: Zehender, M., Meinertz, T., Just, H. (eds) Myocardial Ischemia and Arrhythmia. Steinkopff. https://doi.org/10.1007/978-3-642-72505-0_19

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  • DOI: https://doi.org/10.1007/978-3-642-72505-0_19

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-642-72507-4

  • Online ISBN: 978-3-642-72505-0

  • eBook Packages: Springer Book Archive

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