ArticleJACC. Case reports2026
S-ICD Oversensing of Leadless Atrial Pacing Spikes.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSubcutaneous implantable cardioverter-defibrillators (S-ICDs) and leadless pacemakers (LPs) are increasingly used together, although data on combined use are limited. CASE SUMMARY: A 79-year-old man with ischemic cardiomyopathy and 2 prior episodes of bacteremia requiring transvenous implantable cardioverter-defibrillator lead extraction received an S-ICD. He later developed tachycardia-bradycardia syndrome. Given his prior lead infections, an atrial LP was placed. Testing during implantation revealed high pacing thresholds. Therefore, the LP was programmed to 6 V at 0.4 ms. Remote monitoring noted S-ICD oversensing of the atrial pacing spike. Reduction of his LP amplitude to 1.5 V at 0.4 ms resolved the oversensing. DISCUSSION: The use of S-ICD and ventricular LP is well described and occasionally not feasible due to sensing interference. The use of an atrial LP with an S-ICD is uncommon, and sensing interference is unlikely. This case shows atrial LP interference with S-ICD sensing and highlights possible solutions.
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