![]() These data support that the ICD shock itself has no worse impact on the outcome of ICD patients. Multiple ICD shocks triggered by AF are associated with a worse prognosis in ICD patients, whereas a single shock due to AF or shocks resulting from lead failure are not. 1, 2 Key electrocardiographic findings are a loss of P waves and. ICD shocks caused by AF occurred more often in tandem with a serious adverse event than in patients with a lead failure (15% vs 6%, P < 0.05). Micro-reentry and enhanced automaticity in one or more atrial circuits are the most common triggers for atrial fibrillation. Multiple ICD shocks (≥2) triggered by AF were associated with a worse prognosis, whereas a single shock due to AF or 1 or multiple shocks resulting from lead failure were not. Sixty percent of patients had inappropriate shocks due to AF and 24% due to lead defect or T-wave oversensing. During the median follow-up of 3 years, 297 (21%) patients experienced inappropriate ICD shocks. ![]() The aim of the study was to evaluate the impact of inappropriate ICD shocks on clinical outcome by comparing ICD shocks triggered by atrial fibrillation (AF) with shocks caused by lead failure.Ī total of 1,411 consecutive patients of the prospective single-center ICD-registry Ludwigshafen who underwent an ICD implantation between 19 for primary or secondary prevention of sudden cardiac death were analyzed. Surface ECG, right ventricle (RV), left ventricle (LV), and His bundle pace (HBP) lead electrograms at baseline, during HBP, His-synchronous LV pacing and biventricular pacing are shown. However, it is not known whether the worse impact is attributed to the ICD shock itself or due to the underlying heart disease. His-optimized cardiac resynchronization therapy (CRT) in a patient with chronic atrial fibrillation and intraventricular conduction defect (IVCD). Recent studies suggest a worse impact of inappropriate shock therapies on the outcome of patients with an implantable cardioverter-defibrillator (ICD).
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