title: [Successful defibrillation by disconnection of superior vena cava electrode for high defibrillation threshold: a case report].
abstract: 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.
authors.affiliation: The Second Department of Internal Medicine, Yokohama City University School of Medicine, Yokohama. koheimat@ya2.so-net.ne.jp
authors.forename: Kohei
authors.initials: K
authors.lastname: Matsushita
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Shinichi
authors.initials: S
authors.lastname: Sumita
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Noriko
authors.initials: N
authors.lastname: Kawasaki
authors.forename: Katsumi
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Minoru
authors.initials: M
authors.lastname: Taima
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Uchino
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umemura
mesh_terms: 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*