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Impact factor3.0505 Year impact factor2.664 Published on behalf of Management of patients receiving implantable cardiac defibrillator shocksRecommendations for acute and long-term patient management
Frieder Braunschweig , Giuseppe Boriani , Alexander Bauer , Robert Hatala , Christoph Herrmann-Lingen , Josef Kautzner , Susanne S. Pedersen , Steen Pehrson , Renato Ricci , Martin J. Schalij DOI: http://dx.doi.org/10.1093/europace/euq316
First published online: 25 October 2010
ArticleFigures & dataInformationExplorePDF List of abbreviations
Figure 1 ICD schematic and post-shock emergency algorithm.
Figure 2 Placement of magnet. A pacemaker magnet is placed and fixated over the ICD device. During magnet placement, tachycardia treatments are inhibited while pacemaker functions are preserved. See also Table 2.
Figure 3 (A) Appropriate ICD discharge. Fast VT is detected and a successful shock delivered (arrow). (B) Inappropriate ICD discharge. Fast ventricular rate caused by AF is detected in the VT zone (see marker ‘Ts’) triggering an inappropriate shock delivery. The device has only a ventricular lead making the discrimination between AF and VT difficult. Irregular and short cycle lengths are typical for fast conducted AF (see numbers below annotations). Atrial fibrillation persists, however, with a transiently slower AV conduction. (C) T-wave oversensing. Inappropriate shock caused by T-wave oversensing. In the marker channel (on the top), correct sensing of QRS complexes (Vs) is followed by sensing of T-waves (VF). Ventricular signals have a higher amplitude compared with smaller T-wave signals (lower channel). (D) Artefacts, lead fracture. Inappropriate shock therapy in a patient with lead fracture. Oversensing of noise in the intracardiac electrograms (arrow). In the marker channel (bottom), non-physiological short intervals (<200 ms) are registered (see numbers below annotations).
Figure 4 Supposed vicious circle of shocks and distress.
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View PDF Permissions Frieder Braunschweig , Giuseppe Boriani , Alexander Bauer , Robert Hatala , Christoph Herrmann-Lingen , Josef Kautzner , Susanne S. Pedersen , Steen Pehrson , Renato Ricci , Martin J. Schalij
DOI: http://dx.doi.org/10.1093/europace/euq316