An implantable cardioverter-defibrillator (ICD) delivers a shock to the heart of a patient once it is triggered. Sometimes the shock delivery is appropriate but sometimes it is not.


Conditions when a shock is appropriate:

(1) ventricular fibrillation

(2) ventricular tachycardia (monomorphic or polymorphic)

(3) torsades de pointes


Conditions when a shock is inappropriate - arrhythmia related

(1) atrial fibrillation

(2) atrial flutter

(3) atrial tachycardia

(4) supraventricular tachycardia

(5) junctional tachycardia

(6) sinus tachycardia

(7) premature ventricular contraction (PVC)


Conditions when a shock is inappropriate - device related

(1) triggering by a T wave

(2) double counting of a QRS complex

(3) lead failure or insulation break

(4) triggering by a diaphragmatic myopotential

(5) electromagnetic interference


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