Inadequate high ventricular rate (HVR) diagnosis with BioMonitor 2-AF implantable cardiac monitor due to P-wave oversensing – case report and programming solutions.
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1st Department of Cardiology, Medical University of Warsaw
Damian Małecki   

1st Department of Cardiology, Medical University of Warsaw, ul. Sucharskiego 5/25, 01-390 Warszawa, Poland
Publication date: 2018-03-05
Heart Beat 2018;3:51–53
Implantable cardiac monitors (ICM) are valuable tools for syncope's and arrhythmia’s diagnostic process. However, ICMs may present a significant amount of misqualified records due to artefacts and/or imperfections of diagnostic algorithms. P-wave oversensing (PWOS) is one of the plausible causes of inappropriate automatic analysis. In this report, a case of free-diver with recurrent syncope is investigated. The patient has undergone the implantation of Biomonitor 2-AF of Biotronik GmbH. Soon after implantation high ventricular rhythm (HVR) was registered. Manual analysis of the incident report revealed mild bradycardia and repetitive P-wave and periodic T-wave oversensing misqualified as HVR. Mechanism of PWOS and management options are discussed.