Inappropriate management of self-terminating ventricular arrhythmias by implantable cardioverter defibrillators despite a specific reconfirmation algorithm: a report of two cases.

Algorithms that attempt to reconfirm the presence of an arrhythmia prior to definite treatment have been implemented in ICDs to prevent inappropriate shock therapy due to self-terminating ventricular arrhythmias. Nevertheless, in two patients, clinically inappropriate shocks were delivered after spontaneous conversion of the arrhythmia despite the use of a specific reconfirmation algorithm. Reconfirmation criteria were met due to a premature ventricular complex causing a short cycle in the first patient and a long postextrasystolic pause in the second patient. To avoid inappropriate shock therapy due to self-terminating ventricular arrhythmias, further improvement of detection algorithms is required.