A case of bad timing: inappropriate implantable cardioverter defibrillator therapy due to a critically placed premature ventricular contraction.
A 58-year-old man with an ischemic cardiomyopathy underwent ICD implantation after having an electrophysiological study positive for inducible, sustained monomorphic VT. Approximately 1 week later he experienced a shock. Inspection of stored electrograms revealed that a run of nonsustained VT had initiated his ICD to charge. The episode spontaneously terminated, yet the shock was still delivered during sinus rhythm. Further inspection revealed that a critically timed PVC during the "second look" interval resulted in delivered therapy. Thus, inappropriate ICD therapy can result from causes other than SVT, lead malfunction, or over sensing.
Healy
Edward
E
Department of Medicine, UMass Memorial Medical Center, Worcester, MA 01581, USA.
Ngarmukos
Tachapong
T
Rosenthal
Lawrence
L
D002311:Cardiomyopathy, Dilated / Q000503:physiopathology*; D017147:Defibrillators, Implantable; D004554:Electric Countershock; D006801:Humans; D008297:Male; D008875:Middle Aged; D018879:Ventricular Premature Complexes / Q000503:physiopathology*