Adjustment Operations for Inappropriate Implantable Cardioverter Defibrillator Therapies: Analysis of 3-Year-Follow-Up Data
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概要
- 論文の詳細を見る
<B>Background:</B> It is shown that the implantable cardioverter defibrillator (ICD) shock worsens mortality. The inappropriate ICD shock is also reported to influence mortality. We examined data of the inappropriate ICD therapies and adjustment operations for those events. <B>Method:</B> In our hospital, device data have been checked by an ambulatory practice every 4 months. We analyzed recent 3-year-follow-up data. <B>Result:</B> The inappropriate therapies were observed in 29 cases. In 23 cases therapies were occurred from supraventricular arrhythmia. In 3 cases therapies were from noise emerged from the incomplete lead disconnection and all cases were implanted an additional lead. In 2 cases therapies were from T-wave oversencing. One case was operated generator replacement and one case was adjusted by raising the setting of sensitivity. In 1 case therapies were from VT under-detection and the case was re-programmed by lowered the setting rate. For the supraventricular arrhythmia, the setting rate was raised in 14 cases, the waveform recognition algorithm was adjusted in 7 cases, and SVT time out was extended in two cases. After these adjustment operations the inappropriate therapies decreased or disappeared in all cases. However, 1 case exhibited heart failure progression by continuance of AF tachycardia. <B>Conclusion:</B> the inappropriate ICD therapies can be decreased by operating device settings. But it is necessary to take care of complications of the tachycardia continuance or VT under-detection.
著者
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UEDA Yasunori
Cardiovascular Division, Osaka Police Hospital
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HIRATA Akio
Cardiovascular Division, Osaka Police Hospital
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Hirata Akio
Cardiovascular Division Osaka Police Hospital
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Nakanishi Hiroyuki
Cardiovascular Division Osaka Police Hospital
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Ueda Yasunori
Cardiovascular Division Osaka Police Hospital
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Kashiwase Kazunori
Cardiovascular Division Amagasaki Central Hospital
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Okada Masato
Cardiovascular Division, Osaka Police Hospital
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