It was reported that electrogram (egm) review was requested for this cardiac resynchronization therapy defibrillator (crt-d) system due to an upcoming ventricular tachycardia (vt) ablation.Upon review, intermittent undersensing was observed on the right atrial (ra) lead and automatic gain control (agc) was set to 0.15mv.The ra signal had some noise that was not oversensed.P-wave measurements were 0.08-0.13mv, which was under the programmed floor.It was noted that the patient had a history of atrial fibrillation (af) ablation and atrioventricular junction (avj) ablation.Technical services (ts) reviewed troubleshooting options and programming considerations.There was a noticeable drop in sensing and impedance measurements around (b)(6) 2023, and ts discussed that the procedures may have impacted ra sensing.This crt-d remains in service.No adverse patient effects were reported.
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