Ventricular Fibrillation with Small Amplitude of Activation and its Implications for Implantable Cardioverter Defibrillator Treatment

Masaomi CHINUSHI; Hidehiro KASAI; Minoru TAGAWA; Takashi WASHIZUKA; Yoshifusa AIZAWA

doi:10.1536/jhj.40.87

Masaomi CHINUSHI, Hidehiro KASAI, Minoru TAGAWA, Takashi WASHIZUKA, Yoshifusa AIZAWA

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Keywords: Implantable cardioverter defibrillator, Ventricular fibrillation, Ventricular undersensed beats

JOURNAL FREE ACCESS

1999 Volume 40 Issue 1 Pages 87-90

DOI https://doi.org/10.1536/jhj.40.87

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Abstract

An implantable cardioverter defibrillator (ICD) was implanted in a patient with ventricular fibrillation (VF) related to old myocardial infarction. During VF, amplitude of ventricular activation was small, and the ventricular sensitivity at 1.2 mV failed to detect several small ventricular activations. When the sensitivity was changed to 0.3 mV, both under- and oversensed beats occurred during VF, and at the ventricular sensitivity of 0.15 mV, the undersensed beats disappeared while oversensed beats markedly increased. Defibrillation test was repeated one and four weeks after the implantation, and these inappropriate beats were minimized at the ventricular sensitivity of 0.3 mV. We should pay attention to the amplitude of ventricular activation to avoid possible trouble in ICD therapy.

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