Multicenter investigation of an implantable cardioverter-defibrillator algorithm to detect oversensing

Nicolas Welte, Marc Strik*, Romain Eschalier, Pierre Mondoly, Pascal Defaye, Antonio Frontera, Philippe Ritter, Michel Haissaguerre, Sylvain Ploux, Jayanthi Koneru, Kenneth A. Ellenbogen, Pierre Bordachar

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

10 Citations (Web of Science)

Abstract

BACKGROUND The SecureSense right ventricular (RV) lead noise discrimination algorithm is designed to detect lead fracture and other types of oversensing in order to decrease inappropriate therapy.

OBJECTIVE We studied the real-life accuracy of the SecureSense algorithm in implantable cardioverter-defibrillator (ICD) patients followed by remote monitoring across multiple centers.

METHODS Across 3 French centers, we studied 486 patients with a St Jude Medical device who were followed by remote monitoring and who had the SecureSense algorithm activated. We reviewed

RESULTS SecureSense inhibited 22 inappropriate therapies (lead dysfunction in 10 cases, P-wave oversensing in 12 cases). A total of 57 patients (12%) sent >= 1 nonsustained oversensing episode (total of 393 episodes) with multiple etiologies: noise on the near-field channel (38%), oversensing of T waves during ventricular pacing (33%), oversensing of the sinus P wave (12%), and oversensing of the paced P wave (6%). Two episodes (0.5%) of nonsustained VT were undersensed by the far-field channel. Of 336 analyzed episodes of ventricular tachyarrhythmia, 15 episodes (4%) in 4 patients were related to oversensing of intrinsic P waves in 11 episodes or oversensing of external noise due to electrical cautery for the remaining 4 episodes.

CONCLUSION Of ICD patients equipped with SecureSense, 12% developed episodes of oversensing. The SecureSense algorithm prevented inappropriate ICD therapies with accurate diagnosis of oversensing (caused by lead dysfunction or oversensing of physiological signals). P-wave oversensing in integrated bipolar leads, electrical cautery, and electromagnetic interference are prone to be missed by SecureSense.

Original languageEnglish
Pages (from-to)1008-1015
Number of pages8
JournalHeart Rhythm
Volume14
Issue number7
DOIs
Publication statusPublished - Jul 2017

Keywords

  • Algorithm
  • Devices
  • Electrogram
  • Implantable cardioverter-defibrillator
  • Noise
  • SecureSense
  • St Jude Medical
  • Ventricular fibrillation
  • Ventricular tachycardia
  • SHOCKS
  • PERFORMANCE
  • FAILURE
  • NOISE

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