Avoidance of inappropriate ventricular tachycardia detection due to T-waveoversensing in an implantable cardioverter-defibrillator: An application of the EGM Width Criterion.

Appropriate sensing is an essential function of an implantable cardioverter -defibrillator (ICD). An important clinical problem in ICD recipients is ov ersensing of T waves, which may cause double counting, and result in inappr opriate tachyarrhythmia detection and delivery of device discharges. Decrea sing the sensitivity or programming longer refractory periods can sometimes overcome T wave oversensing, but these measures may interfere with the abi lity of the ICD to detect tachyarrhythmias correctly. We propose a navel ap plication of the EGM Width Criterion, a recently introduced detection enhan cement algorithm that intends to improve ventricular tachycardia (VT) detec tion specificity, to avoid the problem of T wave oversensing. Based on the course of a case with persistent T wave oversensing and review of previousl y published reports, oversensing problems in ICDs and management strategies are discussed.