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KMID : 1011920120130010023
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International Journal of Arrhythmia
2012 Volume.13 No. 1 p.23 ~ p.29
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Troubleshooting ICD therapy
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Choi Kee-Joon
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Abstract
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Implantable cardioverter-defibrillator (ICD) is implanted in patients who have potentially fatal tachyarrhythmia. Appropriate ICD therapy reduces the risk of death from fatal tachyarrhythmia in patients with high risk of sudden death. ICD is programmed to detect and respond to specific criteria indicative of ventricular fibrillation (VF) or ventricular tachycardia (VT). The major problem in patients with ICD is to determine the most appropriate programme settings for ensuring reliable functioning and to prevent inappropriate shock. ICD troubleshooting is occasionally required because of inappropriate ICD sensing or shock application or because patients who require appropriate ICD therapy fail to receive it. In such cases,
the reasons for the inappropriate ICD responses are analyzed and the programmed settings changed if required, or other changes are made to ensure the problem is resolved. With the recent progresses in ICD technology, this technology now has many varied and complex characteristics; therefore, troubleshooting ICD therapy has become a much more complicated and challenging task. Extensive knowledge of the different features and algorithms of ICD is now essential. This review summarizes ICD troubleshooting that we have encountered during ICD follow-up.
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KEYWORD
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Implantable cardioverter-defibrillator (ICD), ventricular tachycardia, ventricular fibrillation
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