70-year-old female with ischemic cardiomyopathy and complete heart block, one month post CRT-D with LBBP implantation
Sensitivity adjustment of the RV lead
Elimination of oversensing
Sensitivity adjustment of the RV lead can successfully eliminate oversensing of atrial signals by the ventricular coil lead during atrial fibrillation in patients with CRT-D and LBBP.
A 70-year-old female with ischemic cardiomyopathy and complete heart block presented with recurrent syncope and an episode of massive chest pain, one month after CRT-D with LBBP implantation. Device interrogation revealed oversensing of atrial signals by the ventricular coil lead during atrial fibrillation leading to inappropriate VF detection, which was causing both inappropriate pacing inhibition and shock delivery. Sensitivity adjustment of the RV lead successfully eliminated oversensing. This case is a unique occurrence of a double inappropriate response to oversensing. We discuss in detail the reasons behind oversensing and steps for optimization of programming to treat such adverse events.
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Sharon Jebamalar
Selva Maheshwari
Usnish Adhikari
IHJ Cardiovascular Reports
Heart Rhythm Society
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Jebamalar et al. (Fri,) studied this question.
www.synapsesocial.com/papers/69fd7d4abfa21ec5bbf05dfd — DOI: https://doi.org/10.1016/j.ihjcvr.2026.05.003