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When Low Voltage Sparks High Drama: ICD Therapy in Ventricular Tachycardia.

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Title: When Low Voltage Sparks High Drama: ICD Therapy in Ventricular Tachycardia.
Authors: Goel, Shivam1 (AUTHOR), Kumar, Sumit1 (AUTHOR), Deepti, Siddharthan1 (AUTHOR) deeptikailath@gmail.com, Parakh, Neeraj1 (AUTHOR), Sharma, Gautam1 (AUTHOR), Naik, Nitish1 (AUTHOR)
Source: Pacing & Clinical Electrophysiology. May2026, Vol. 49 Issue 5, p576-580. 5p.
Subjects: Electric countershock, Cardiomyopathies, Electroconvulsive therapy, Ventricular tachycardia, Implantable cardioverter-defibrillators, Catheter ablation, Electrophysiology, Myocardial depressants, Algorithms
Abstract: The article focuses on a case involving inappropriate shock delivery by a cardiac resynchronization therapy defibrillator (CRT-D) in a 61-year-old woman with non-ischemic cardiomyopathy and recurrent slow ventricular tachycardia (VT). The device’s VF/VT Therapy Assurance (VFTA) algorithm, designed to prevent under sensing of ventricular arrhythmias by detecting low-amplitude far-field signals and long RR intervals, temporarily reprogrammed the device to deliver a shock instead of the programmed anti-tachycardia pacing (ATP). Although the shock successfully terminated the VT, the algorithm’s reliance on far-field electrograms led to inappropriate therapy due to low voltage signals in this patient. The case highlights the need for individualized programming of the VFTA algorithm to avoid unnecessary shocks in patients with advanced cardiomyopathy. [Extracted from the article]
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Database: Engineering Source
Description
Abstract:The article focuses on a case involving inappropriate shock delivery by a cardiac resynchronization therapy defibrillator (CRT-D) in a 61-year-old woman with non-ischemic cardiomyopathy and recurrent slow ventricular tachycardia (VT). The device’s VF/VT Therapy Assurance (VFTA) algorithm, designed to prevent under sensing of ventricular arrhythmias by detecting low-amplitude far-field signals and long RR intervals, temporarily reprogrammed the device to deliver a shock instead of the programmed anti-tachycardia pacing (ATP). Although the shock successfully terminated the VT, the algorithm’s reliance on far-field electrograms led to inappropriate therapy due to low voltage signals in this patient. The case highlights the need for individualized programming of the VFTA algorithm to avoid unnecessary shocks in patients with advanced cardiomyopathy. [Extracted from the article]
ISSN:01478389
DOI:10.1111/pace.70193