CARDIAC-RHYTHM PRECIPITATING AUTOMATIC IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR DISCHARGE IN OUTPATIENTS AS DETECTED FROM TRANSTELEPHONIC ELECTROCARDIOGRAPHIC RECORDINGS

The automatic implantable cardioverter-defibrillator (AICD) has become a mainstay in the nonpharmacologic management of sustained ventricular tachyarrhythmias.1 One of the most significant management problems for the AICD population is that of AICD discharge for cardiac rhythms other than sustained ventricular tachyarrhythmias, the rhythms that the AICD was designed to sense and terminate.2-5 This type of AICD discharge has been termed "inappropriate," "spurious," or "false positive," can be due to a variety of cardiac rhythms, and, if recurrent, may be associated with deleterious medical or psychological consequences.1 Although the problem clearly exists, the occurrence of inappropriate AICD discharges is difficult to define in clinical practice because the current AICD system has no internal memory or telemetry functions to document the rhythms that precipitated the AICD discharge. There is little published information that documents the cause of AICD discharges in an outpatient population. The objective of this study was to survey the records of all AICD outpatients enrolled in a transtelephonic electrocardiogram monitoring service, and to review the records for (1) the cardiac rhythms responsible for the AICD discharges, and (2) the patients' symptoms preceding the AICD discharge. © 1991.