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Open Access 01-09-2017 | Rhythm Puzzle - Answer
Adequate sensing of ventricular fibrillation?
Published in: Netherlands Heart Journal | Issue 9/2017
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The first part of the recording (Fig. 1) shows continuous atrial fibrillation (AF) with biventricular pacing. After a single T‑wave is oversensed (1), the device automatically adjusts the sensitivity based on the amplitude of the preceding sense event [1]. This more sensitive setting leads to detection of AF in the ventricular channel, interpreted as ventricular fibrillation (VF) and abortion of ventricular pacing (2). After approximately 9 s, AF oversensing has stopped spontaneously, biventricular pacing is resumed and VF therapy is aborted (3).
Fig. 1
After atrial fibrillation with biventricular pacing (upper panel), there is a sudden change initiated by ventricular oversensing (1). Subsequently, atrial fibrillation is sensed in the ventricular channel (2); note the synchrony between atrial and ventricular sense markers in the lower channel. There is a spontaneous abortion of atrial oversensing (3) and restoration of biventricular pacing
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