Unusually high His-bundle signal amplitude — ICD sensing considerations
Abstract
In patients with chronic atrial fi brillation and congestive heart failure presenting with narrow QRS complex the direct
His-bundle pacing the use of dual chamber implantable cardioverter-defibrillator can be a defi nite treatment option
meeting all therapeutic goals. This approach enables heart rate regularization, appropriate increase of beta-blocker
dose with additional benefi t in terms of arrhythmic death prophylaxis. The proper functioning of implantable cardioverter-
-defibrillator demands appropriate atrial channel/His-bundle signal sensing. The low His-bundle electrogram amplitude
usually does not interfere with the device function and the DDI or DVI programming modes are reasonable.
The authors present a case of unusually high His-bundle signal amplitude sensed by atrial channel of implantable cardioverter-defibrillator, which could potentially contribute to some particular programming considerations. The attending physician should be aware of some arrhythmia discriminators which may delay or even withhold the appropriate shock.
Keywords: atrial fi brillationcongestive heart failuredirect His-bundle pacingimplantable cardioverter-defibrillator
References
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