Alert message for ventricular arrhythmia: episode of classified ventricular fibrillation Patient

Tracing
N° 13
Manufacturer Biotronik Device Remote monitoring Field Messages and events
Patient

This 39-year-old man received a Lumax 340 VR-T single chambre defibrillator for management of Brugada syndrome with syncope; an alert message was transmitted 2 years after device implantation.

Graph and trace

Telemedicine report

Alert message (yellow status) for episode of classified ventricular fibrillation.

The report shows that the patient sustained an episode diagnosed in the ventricular fibrillation zone, with interruption of the capacitors charge and no shock delivery. Analysis of the EGM shows a typical aspect of intermittent oversensing of the T wave.

Comments

The last two tracings illustrate an important advantage of follow-ups with telemedicine: prevention of inappropriate therapies. In view of this alert message, the patient was contacted the next day, and seen in face-to-face consultation to reprogram the ventricular sensing and eliminate T wave sensing, which solved the problem and prevented all further inappropriate therapies.

The last three tracings correspond to the same diagnosis of ventricular fibrillation by the device; however, they represent different circumstances, namely a) a true ventricular tachycardia, b) oversensing of 50 Hz signal, and c) oversensing of the T-wave. Analysis of the EGM allows the confirmation or rejection of the diagnosis made by the device and adapt the subsequent follow-up.