A 67-year-old man with an implantable-cardioverter defibrillator (ICD) phoned our Department of Cardiology to report the occurrence of palpitations and dizziness. He was implanted two years before with a dual-chamber ICD (Energen F143, Boston Scientific, Natick, MA, USA) in primary prevention for dilated cardiomyopathy with severely reduced left ventricular ejection fraction, without complication.
The device was programmed in DDI pacing mode in order to maintain atrial sensing and to assess the clinical burden of paroxysmal persistent atrial fibrillation. As the patient was followed with the wireless Remote monitoring, he was told to send a transmission to the hospital; the device was interrogated and two episodes of non sustained ventricular tachycardia with a maximum duration of eight seconds were observed. Electrical parameters were normal and similar to those at implantation. Analyzing EGMs, the physicians noticed that ventricular tachycardias were triggered by a particular, unusual way (Figure 1A).
Published on: Sep 25, 2014 Pages: 33-34