August 2018

Remote alert for non-sustained RV oversensing episode

Matt Swift – Lead Cardiac Physiologist CRM
Great Western Hospital, Marlborough Road, Swindon, Wiltshire, SN3 6BB
matthew.swift2@nhs.net

with credit to Rob Williams from Abbott for assisting with the images

Background

A home monitoring transmission was received 9 months post implant for a 59-year-old male with an Abbott CRT-D. The transmission was sent due to an alert triggered for non-sustained RV oversensing, detected by the SecureSense algorithm on the device. An EGM from the transmission is displayed below.

Figure 1
Stored electrogram of a non-sustained RV oversensing episode.  Top to bottom, atrial electrogram, right ventricular near field electrogram, far field discrimination channel, marker channel.

THE QUESTION

What is behind the non-sustained RV oversensing episodes?

  • T wave oversensing

  • Intermittent Loss of RV Capture

  • Diaphragmatic myopotential oversensing

  • Electromagnetic Interference

  • Electromagnetic Interference