Baranchuk Adrian, Ribas Sebastian, Divakaramenon Syamkumar, Morillo Carlos A
Arrhythmia Service, McMaster University, Hamilton Health Sciences Corporation, Hamilton, Ontario, Canada.
Europace. 2007 Aug;9(8):694-6. doi: 10.1093/europace/eum056. Epub 2007 May 3.
Inappropriate shocks delivered by the implantable cardioverter defibrillator (ICD) are an increasingly recognized complication. The most frequent cause is related to supraventricular rhythms associated with fast conduction to the ventricles that are incorrectly detected as ventricular tachycardia leading to inappropriate antitachycardia pacing and/or shocks. Oversensing is a frequent cause of inappropriate shocks usually due to increased amplitude of the T-wave secondary to ischaemia or electrolyte disorders that lead to T-wave double counting. We describe an unusual case of T-wave double counting during sinus rhythm caused by transient reduction in R-wave amplitude with no changes in T-wave amplitude resulting in inappropriate shocks.
植入式心脏复律除颤器（ICD）发放不恰当电击是一种日益受到重视的并发症。最常见的原因与室上性心律有关，这种心律伴有快速下传至心室，被错误地检测为室性心动过速，从而导致不恰当的抗心动过速起搏和/或电击。感知过度是不恰当电击的常见原因，通常是由于缺血或电解质紊乱导致T波振幅增加，进而引起T波双重计数。我们描述了一例罕见病例，窦性心律时因R波振幅短暂降低而T波振幅无变化导致T波双重计数，进而引发不恰当电击。
