ICD Repacing
A week ago, I had some rapid HR on a Sunday, and messaged my EP asking if anything was caught in the nightly download of info. I got a call back telling me that "no", nothing was flagged or alerted and sent to email, but they had me do an interrogation then. It showed 2 episodes of VT about a minute a part and showed the ICD was able to repace the heart both times. (Good to know it's working..) My question: Would one expect for a repacing due to VT be part of the parameters set to email notify the EP after the nightly download I've had the ICD since September. This is the first report I've received that the ICD repaced a VT. Just had an in-office interrogation and it only showed one NSVT in 3 months (I've had more that were shorter than those the ICD is set to record.
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ICD reports
by Gemita - 2024-06-18 16:24:11
Gramzo, how are you?
Your question:
Would one expect for a re-pacing due to VT to be part of the parameters set to email notify the EP after the nightly download? I've had the ICD since September.
Not necessarily. The EP knows you are safe which is why you have an ICD to watch over you. A non sustained VT episode (less than 30 seconds) that stops on its own would not necessarily be sent by email to your EP for urgent follow up. However, all non sustained VT episodes that meet the criteria (parameters) set up by your EP for their recording and storage, should be stored so that your EP can see the extent of the problem and whether your non sustained VT episodes are getting more frequent and longer lasting. He can then decide how to treat these more effectively with medication or settings adjustments.
My non sustained VT episodes are stored and reported if they exceed 150 bpm. For example I had one 8 second run of non sustained VT a few days ago but it certainly didn't excite my EP! Now if it had been over 30 seconds that would have been a different matter and in your case you would probably have received anti tachycardia pacing and if that didn't work, a shock.
Sustained ventricular tachycardia is defined as tachycardia that continues for more than 30 seconds or leads to hemodynamic compromise within 30 seconds and requires intervention. On the other hand, non-sustained ventricular tachycardia lasts less than 30 seconds and does not usually cause hemodynamic instability, although this would very much depend on your heart condition. For example, with heart failure, long runs of non sustained VT wouldn't perhaps be well tolerated.
You did absolutely the right thing to alert your clinic. They need to know when we are "symptomatic".