| Autor: |
Yuji Ishida, MD, PhD, Shingo Sasaki, MD, PhD, Yuichi Toyama, MD, Kimitaka Nishizaki, MD, PhD, Yoshihiro Shoji, MD, PhD, Takahiko Kinjo, MD, PhD, Taihei Itoh, MD, PhD, Daisuke Horiuchi, MD, PhD, Masaomi Kimura, MD, PhD, Michael R. Gold, MD, PhD, FHRS, Hirofumi Tomita, MD, PhD |
| Jazyk: |
angličtina |
| Rok vydání: |
2020 |
| Předmět: |
|
| Zdroj: |
Heart Rhythm O2, Vol 1, Iss 1, Pp 27-34 (2020) |
| Druh dokumentu: |
article |
| ISSN: |
2666-5018 |
| DOI: |
10.1016/j.hroo.2020.01.002 |
| Popis: |
Background: The subcutaneous implantable cardioverter-defibrillator (S-ICD) is effective in preventing sudden cardiac death. Compared with transvenous ICDs, S-ICDs have a lower rate of inappropriate shocks (IASs) for supraventricular arrhythmias, but such shocks for T-wave oversensing (TWO) and extracardiac myopotentials are more common. No screening tests to identify patients at risk for IAS due to myopotential interference (MPI) currently are available. Objective: The purpose of this study was to assess the efficacy of a tube exercise test (TET) developed to detect MPI post S-ICD implantation. Methods: TET includes 3 different maneuvers using an exercise tube. S-ICD electrograms were recorded to assess MPI while patients performed each of the maneuvers. Results: TET was performed in 43 patients, and MPI was observed in 12 patients (28%). In 10 of the 12 TET-positive patients, the positive vector corresponded with a vector that did not show TWO on standard S-ICD preoperative screening. During median follow-up of 672 days (interquartile range 465–805 days), 3 patients (7%) experienced IAS due to MPI. Importantly, the vector at the time of IAS in all 3 patients passed standard preoperative screening for TWO but was positive with TET. Sensitivity and specificity of TET were 100% and 78%, respectively, and positive and negative predictive values were 25% and 100%, respectively. Conclusion: Postimplant screening for MPI identified patients at increased risk for IAS. TET may be helpful for guiding optimal programming to prevent IAS. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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