[Successful defibrillation by disconnection of superior vena cava electrode for high defibrillation threshold: a case report].
A 72-year-old man with dilated cardiomyopathy and sustained ventricular tachycardia was treated with amiodarone. He visited another hospital because of loss of consciousness. Electrocardiography showed 2: 1 atrioventricular block. Ambulatory electrocardiography showed total heart beats were 59,700 per day. He was referred to our hospital to evaluate his heart. Several types of ventricular tachycardia and ventricular fibrillation were induced by program stimulation during the electrophysiological study. Therefore, an implantable cardioverter-defibrillator was introduced. During defibrillation threshold tests, ventricular fibrillation could not be terminated by the maximal output of 31J. Despite changing the polarity and lead position, stable defibrillation could not be obtained. Finally, successful defibrillation could only be achieved by disconnection of the superior vena cava electrode.
Matsushita
Kohei
K
The Second Department of Internal Medicine, Yokohama City University School of Medicine, Yokohama. koheimat@ya2.so-net.ne.jp
Ishikawa
Toshiyuki
T
Sumita
Shinichi
S
Kobayashi
Tsukasa
T
Kawasaki
Noriko
N
Matsumoto
Katsumi
K
Taima
Minoru
M
Uchino
Kazuaki
K
Kimura
Kazuo
K
Umemura
Satoshi
S
D000368:Aged; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000379:methods*; D004562:Electrocardiography; D004566:Electrodes; D006801:Humans; D008297:Male; D014683:Vena Cava, Superior; D014693:Ventricular Fibrillation / Q000628:therapy*