{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T02:04:07Z","timestamp":1762999447149,"version":"3.40.5"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,3,26]],"date-time":"2019-03-26T00:00:00Z","timestamp":1553558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There are anecdotal reports of sudden death despite a functional implantable cardioverter defibrillator (ICD). We sought to describe scenarios leading to fatal or near\u2010fatal outcome due to inappropriately inhibited ICD therapy in devices programmed with single\u2010chamber detection criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Programmed settings, episode lists, and intracardiac electrograms from 24 patients with a life\u2010threatening event (n\u00a0=\u00a012) or fatal outcome (n\u00a0=\u00a012) related to failed ventricular arrhythmia detection were used to clarify the underlying scenario.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty episodes of failed ventricular arrhythmia detection were identified and categorized into six scenarios: (1) spontaneous ventricular tachycardia (VT) or ventricular fibrillation (VF) with a rate below the detection limits, (2) misclassification of polymorphic VT (PVT) or VF as supraventricular tachycardia (SVT), (3) misclassification of VT\/VF as cluster of nonsustained VT episodes, (4) misclassification of monomorphic VT (MVT) as SVT, (5) inappropriate shock abortion, and (6) false termination detection. These scenarios occurred respectively 6, 9, 3, 9, 8, and 15 times. In 9\/9 (100%) patients with PVT\/VF classified as SVT, rate stability was active for rates ranging from 222 to 250\u00a0beats\/min. MVT detected as SVT was due to the sudden onset criterion in 7\/9 (78%) patients and twice a consequence of the rate stability criterion active for rates ranging from 200 to 250\u00a0beats\/min.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We describe six scenarios leading to failure of ventricular arrhythmia detection in a single\u2010chamber detection setting withholding life\u2010saving therapy. These scenarios are more likely to occur with high\u2010rate programming and long detection times, especially if combined with rate stability and sudden onset.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.13610","type":"journal-article","created":{"date-parts":[[2019,1,18]],"date-time":"2019-01-18T11:55:16Z","timestamp":1547812516000},"page":"583-594","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Failure to detect life\u2010threatening arrhythmias in ICDs using single\u2010chamber detection criteria"],"prefix":"10.1111","volume":"42","author":[{"given":"Roland X.","family":"Stroobandt","sequence":"first","affiliation":[{"name":"Heart Center Ghent University Hospital  Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mattias F.","family":"Duytschaever","sequence":"additional","affiliation":[{"name":"Heart Center Ghent University Hospital  Ghent Belgium"},{"name":"Department of 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