Electrical storm of monomorphic ventricular tachycardia after a cardiac-resynchronization-therapy-defibrillator upgrade.
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.
Kantharia
Bharat K
BK
Division of Cardiology, Albert Einstein Medical Center, 5501 Old York Road, Levy 3 East, Philadelphia, PA, USA. bkantharia@yahoo.com
Patel
Jigar A
JA
Nagra
Bipinpreet S
BS
Ledley
Gary S
GS
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
D000889:Anti-Arrhythmia Agents