Abstract 2876: Effectiveness of Band-pass Filter Optimization to Avoid Ventricular Sensing Failure by Novel Implantable Cardioverter Defibrillators
Background: Troubleshooting of inappropriate therapies due to sensing failure is still challenging in patients with implantable cardioverter defibrillator (ICD). Novel ICD devices which can optimize the band-pass filter for ventricular sensing have recently been developed.
Objective: The purpose of this study was to evaluate the efficacy of band-pass filter optimization using Lexos™ or Lumax™ (Biotronik GmbH &Co. KG, Germany).
Methods: Twenty two patients who underwent implantation of Lexos™ or Lumax™ were investigated prospectively using the ICD’s capability to independently change the settings of the high-pass filter (HPF) and the low-pass filter (LPF). The intracardiac R wave and the T wave during sinus rhythm, and the fibrillation wave during induced ventricular fibrillation (VF) were measured by the device under 5 different combinations of HPF and LPF as shown in the figure⇓.
Results: Change in the amplitude of R wave and T wave according to the HPF and LPF setting is shown in the figure⇓. During sinus rhythm, the “T suppression” and “LPF maximum” setting could reduce T wave amplitude while maintaining relatively high R wave amplitudes, suggesting the effectiveness of band-pass filter optimization for the avoidance of T wave oversensing. During induced VF, the fibrillation wave amplitude is better in “LPF maximum” than “T suppression”. Undersensing of VF was not seen in all settings.
Conclusions: Band-pass filter optimization is useful to enhance R wave, to avoid T wave oversensing and to obtain better VF sensing. In patients with ventricular sensing problems, this technology may offer a simple troubleshooting solution to what otherwise may lead to major complications.