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As of December 2004, ICDs had been implanted in 8 patients
with SQTS for primary and secondary prevention of sudden cardiac death.
We implanted ICDs (Guidant Vitality AVT A135) for primary prevention in
three of our patients, and during one-year follow-up, no shocks were
delivered and the overall treatment was without complications.
Schimpf R el al reported their experience with ICD
implantation in five patients with SQTS (one Medtronic, Inc. and four
St. Jude Medical, Inc.). Despite normal sensing behavior during
intraoperative and postoperative device testing, three patients
experienced inappropriate shock therapies for T-wave oversensing 30 +/-
26 days after implantation (one Medtronic Marquis VR 7230, one St. Jude
Atlas VR V-199 and one St. Jude Photon Micro VR-194 ICD).
Re-programming of the decay delay (St. Jude) and/or the sensitivity (St.
Jude, Medtronic) prevented further inappropriate discharges, but the
high incidence of T-wave oversensing by ICDs in patients with SQTS calls
for special attention to device selection and options available for
re-programming post-implantation.
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