Undersensing of VF in a patient with optimal R wave sensing during sinus rhythm

L.R.C. Dekker, T.A.M. Schrama, F.H.L. Steinmetz, R. Tukkie

Research output: Contribution to journalArticleAcademicpeer-review

26 Citations (Scopus)


We describe a case of potentially fatal undersensing of VF by a third generation ICD with predetermined automatic gain control. In this patient, ventricular sensing was optimal, as R wave amplitudes during sinus rhythm were at least 16 mV. Cyclical, high amplitude signals during VF elevated the sensing floor to such an extent that complete undersensing of subsequent lower amplitude local electrograms occurred. This led to bradypacing and complete ICD therapy failure. Therefore, high R wave amplitudes during sinus rhythm do not warrant flawless sensing during VF.

Original languageEnglish
Pages (from-to)833-4
Number of pages2
JournalPacing and Clinical Electrophysiology : PACE
Issue number6 Pt 1
Publication statusPublished - Jun 2004
Externally publishedYes


  • Aged
  • Aged, 80 and over
  • Defibrillators, Implantable
  • Electrocardiography
  • Equipment Failure Analysis
  • Heart Rate
  • Humans
  • Male
  • Microcomputers
  • Sensitivity and Specificity
  • Software
  • Ventricular Fibrillation


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