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  • Title: Shocking truths about implantable cardioverter defibrillator monitoring zones.
    Author: Mansour F, Thibault B, Dubuc M, Guerra PG, Macle L, Brugada R, Roy D, Talajic M, Khairy P.
    Journal: Pacing Clin Electrophysiol; 2007 Sep; 30(9):1146-8. PubMed ID: 17725760.
    Abstract:
    A 36 year-old man with hypertrophic cardiomyopathy and an ATLAS + DR implantable cardioverter defibrillator (ICD) (St. Jude Medical, Inc., St. Paul, MN, USA) for primary prevention received a shock while cycling. The ventricular fibrillation detection threshold was 182 beats/min. An additional monitoring zone was programmed to 156 beats/min with all discriminators "on" except morphology. On interrogation, the ICD shock followed sinus tachycardia. In the absence of a monitoring zone, device therapy would not have been expected. We explore the mechanisms by which monitoring zones could potentially contribute to inappropriate ICD therapy and offer trouble-shooting tips.
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