Hyperglycemia-Induced T-Wave Oversensing as a Cause of Cardiac Resynchronization Therapy (CRT) Failure
T-wave oversensing occurs when the counter starts giving dual beeps for every cardiac cycle instead of one. This usually happens when the monitoring lead displays a tall T wave, which is also sharp. R wave sensing algorithms of the devices do not sense T wave because the slow rate of the T wave is m...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Tehran University of Medical Sciences
2012-01-01
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| Series: | Journal of Tehran University Heart Center |
| Subjects: | |
| Online Access: | https://jthc.tums.ac.ir/index.php/jthc/article/view/238 |
| Summary: | T-wave oversensing occurs when the counter starts giving dual beeps for every cardiac cycle instead of one. This usually happens when the monitoring lead displays a tall T wave, which is also sharp. R wave sensing algorithms of the devices do not sense T wave because the slow rate of the T wave is much less than that of the R wave. But the slow rate of T waves may change with time and also because of parameters like potassium levels and hyperglycemia. We present a 67-year-old female who underwent the implantation of cardiac resynchronization therapy (cardiac resynchronization and implantable cardioverter defibrilator [CRT-D]) because of severe left ventricular systolic dysfunction and ventricular dyssynchrony experienced recurrent inappropriate implantable cardioverter-defibrillator (ICD) shocks and CRT failure. Device analysis showed that the CRT failure was in consequence of T-wave oversensing due to hyperglycemia. Elimination of the T-wave oversensing after hyperglycemia control conferred good biventricular pacing and good response to CRT during a 6-month follow-up period.
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| ISSN: | 1735-8620 2008-2371 |