T波感知过度与不恰当电击：一例病例报告
T-wave oversensing and inappropriate shocks: a case report.
作者信息
Srivathsan Komandoor, Scott Luis R, Altemose Gregory T
机构信息
Mayo Clinic Arizona-Mayo Clinic Hospital, Cardiovascular Diseases, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA.
出版信息
Europace. 2008 May;10(5):552-5. doi: 10.1093/europace/eun083.
A 27-year-old male with congenital long QT syndrome, SCN5A mutation experienced recurrent inappropriate exercise-related implantable cardioverter defibrillator (ICD) shocks. This device showed T-wave oversensing with double, which lead to these device discharges. Dynamic T-wave oversensing was reproducibly provoked at exercise treadmill testing and was confirmed as the mechanism leading to double counting. The insertion of a new pacing and sensing lead with increased R-wave amplitude did not solve the problem. Exchanging the existing ICD generator with one capable of automatic sensitivity control (Biotronik, Lexos DR, Biotronik, Berlin, Germany) completely eliminated T-wave oversensing and inappropriate shocks.
一名27岁男性，患有先天性长QT综合征，携带SCN5A突变，经历了与运动相关的反复不适当的植入式心律转复除颤器（ICD）电击。该设备显示T波过度感知呈双峰，这导致了设备放电。在运动平板试验中可重复诱发动态T波过度感知，并被确认为导致双重计数的机制。插入一个具有更高R波振幅的新起搏和感知导线并不能解决问题。将现有的ICD发生器换成一个能够进行自动灵敏度控制的发生器（百多力公司，Lexos DR，百多力公司，德国柏林），完全消除了T波过度感知和不适当的电击。
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