Predictor for Inappropriate Shocks Due to T Wave Oversensing Using the R and T Wave Amplitudes of Ventricular Bipolar Electrograms in Implantable Cardioverter-Defibrillator Systems

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Introduction: The information about the predictor for inappropriate shocks due to T wave oversensing using the electrograms in implantable cardioverter-defibrillator (ICD) systems is not available. Methods: 13 consecutive patients (male: 12, age: 48±15 y/o) who underwent ICD (Lexos DR and Lumax 340 DR-T, Biotronik) implantation were included. We measured amplitude of bipolar electrograms from ventricular lead. Results: We evaluated the comparisons of the R and T wave amplitudes between Brugada (group B) (n=5) and non-Brugada (group NB) (n=8) syndrome. There was no significant difference in the R wave amplitude (peak-to-peak amplitudes) between group B and NB. On the other hand, T wave amplitude in group B was significantly higher than that in group NB (B vs. NB, p<0.01). The existence of Brugada syndrome and T/R ratio during the AAI with a high-pass filter setting of 10/20 Hz was an excellent predictor of T wave oversensing in the follow-up period. Conclusions: These findings have important implications for inappropriate shocks due to T wave oversensing.