Ventricular arrhythmia detection for contemporary Biotronik and Abbott implantable cardioverter defibrillators with markedly prolonged detection in Biotronik devices,Journal of Interventional Cardiac Electrophysiology

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Ventricular arrhythmia detection for contemporary Biotronik and Abbott implantable cardioverter defibrillators with markedly prolonged detection in Biotronik devices
Journal of Interventional Cardiac Electrophysiology ( IF 2.1 ) Pub Date : 2023-02-04 , DOI: 10.1007/s10840-023-01498-9
Adam Oesterle ₁ , Sanket S Dhruva ₁ , Cara N Pellegrini ₁ , Bing Liem ₁ , Merritt H Raitt ₂

Affiliation

Background

Implantable cardioverter defibrillators (ICDs) are typically programed with both ventricular tachycardia (VT) and ventricular fibrillation (VF) treatment zones. Biotronik and Abbott ICDs do not increment the VT counter when the tachycardia accelerates to the VF zone, which could result in a prolonged delay in tachycardia detection.

Methods

Patients with Biotronik and Abbott ICDs receiving care at Veterans Affairs facilities in Northern California were identified. Patient information and device tracings for patients with any ICD therapies were examined to assess for possible delayed tachycardia detection.

Results

Among 52 patients with Biotronik ICDs, 8 (15%) experienced appropriate ICD therapy over a median follow-up of 29 months. Among 68 patients with Abbott ICDs, 26 (38%) experienced appropriate ICD therapy over a median follow-up of 83 months. Three of the patients with Biotronik ICDs who received appropriate therapy experienced a delay in VT/VF detection due to the tachycardia rate oscillating between the VT and VF treatment zones (longest 31.2 s on detection), compared with four of the patients with Abbott ICDs (longest 4.1 s on the detection and 8 s on redetect). One of the patients with a Biotronik ICD experienced recurrent syncope associated with delayed detection and another died on the day of delayed detection. One of the patients with an Abbott ICD experienced syncope.

Conclusions

Because contemporary Biotronik and Abbott ICDs freeze the VT counters when tachycardia is in the VF zone, ICD therapies can be markedly delayed when the tachycardia oscillates between the VT and VF zone.

中文翻译：

现代 Biotronik 和 Abbott 植入式心律转复除颤器的室性心律失常检测，在 Biotronik 设备中检测时间显着延长

背景

植入式心律转复除颤器 (ICD) 通常针对室性心动过速 (VT) 和心室颤动 (VF) 治疗区进行编程。当心动过速加速至心室颤动区时，Biotronik 和 Abbott ICD 不会增加 VT 计数器，这可能会导致心动过速检测延迟较长。

方法

确定了在北加州退伍军人事务机构接受护理的佩戴 Biotronik 和 Abbott ICD 的患者。检查接受任何 ICD 治疗的患者的患者信息和设备追踪，以评估可能的延迟性心动过速检测。

结果

在 52 名使用百多力 ICD 的患者中，8 名 (15%) 在中位随访 29 个月的时间里接受了适当的 ICD 治疗。在 68 名使用 Abbott ICD 的患者中，26 名 (38%) 在中位随访 83 个月的时间里接受了适当的 ICD 治疗。接受适当治疗的百多力 ICD 患者中，三名患者由于心动过速在 VT 和 VF 治疗区之间振荡而出现 VT/VF 检测延迟（检测时最长 31.2 秒），而四名使用 Abbott ICD 的患者则出现了 VT/VF 检测延迟（检测时最长 31.2 秒）。检测时最长 4.1 秒，重新检测时最长 8 秒）。其中一名佩戴百多力 ICD 的患者因延迟检测而出现反复晕厥，另一名患者在延迟检测当天死亡。一名佩戴 Abbott ICD 的患者出现晕厥。