title: Electrical storm of monomorphic ventricular tachycardia after a cardiac-resynchronization-therapy-defibrillator upgrade.
abstract: In patients with significant left ventricular dysfunction and congestive heart failure despite optimal medical therapy, implantation of cardiac resynchronization therapy-defibrillation (CRT-D) devices has been shown to improve symptoms and mortality. In this report, we describe a case of a patient with ischaemic cardiomyopathy who developed incessant ventricular tachycardia (VT) after undergoing an upgrade from an implantable cardioverter defibrillator to a CRT-D device. The patient required multiple anti-arrhythmic agents, removal of the coronary sinus lead, and radiofrequency ablation to control VT. Thus, in rare patients, the CRT devices may potentially cause 'proarrhythmia' with serious consequences.
authors.affiliation: Division of Cardiology, Albert Einstein Medical Center, 5501 Old York Road, Levy 3 East, Philadelphia, PA, USA. bkantharia@yahoo.com
authors.forename: Bharat K
authors.initials: BK
authors.lastname: Kantharia
authors.forename: Jigar A
authors.initials: JA
authors.lastname: Patel
authors.forename: Bipinpreet S
authors.initials: BS
authors.lastname: Nagra
authors.forename: Gary S
authors.initials: GS
authors.lastname: Ledley
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004562:Electrocardiography; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000628:therapy; D017180:Tachycardia, Ventricular / Q000209:etiology* / Q000503:physiopathology* / Q000628:therapy
chemical_list: D000889:Anti-Arrhythmia Agents