Use of a coronary sinus lead and biventricular ICD to correct a sensing abnormality in a patient with arrhythmogenic right ventricular dysplasia/cardiomyopathy.
Implantable cardioverter defibrillators (ICDs) are frequently offered to patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). Yet ICDs in these patients may be complicated by poor sensed amplitudes resulting from fatty and fibrous tissue replacement of right ventricular myocardium. We present the case of a patient with ARVD/C who had inappropriate detection of ventricular tachycardia with a single-chamber ICD due to poor sensed right ventricular amplitudes. We discuss how the use of a bipolar coronary sinus lead and a biventricular ICD generator with a novel header configuration solved the problem.
Bilchick
Kenneth C
KC
Division of Cardiology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Judge
Daniel P
DP
Calkins
Hugh
H
Marine
Joseph E
JE
D000328:Adult; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000628:therapy*; D009202:Cardiomyopathies / Q000628:therapy*; D017147:Defibrillators, Implantable; D003951:Diagnostic Errors; D004562:Electrocardiography; D004868:Equipment Failure; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D017180:Tachycardia, Ventricular / Q000175:diagnosis