title: Transvenous dual site left ventricular pacing plus biventricular pacing for the management of refractory ventricular tachycardia.
abstract: This is a case report of a male patient with nonischemic cardiomyopathy who had severely depressed left ventricular systolic function and functional class III congestive heart failure (CHF). He also had left bundle branch block (LBBB) and recurrent ventricular tachycardia (VT). Though the patient's CFH functional class improved after implantation of a transvenous biventricular ICD system, recurrent VT episodes required the initiation of amiodarone. After an improved condition for 28 months, recurrent VT episodes led to multiple consecutive ICD shocks, which constituted an electrical storm and a battery status of elective replacement indicator (ERI). The recurrent VT episodes were suppressed with intravenous amiodarone and lidocaine. As Radiofrequency ablation was declined by the patient, a new left ventricular (LV) lead was transvenously added, providing biventricular and dual site LV pacing. After this intervention the arrhythmia subsided and the intravenous antiarrhythmic medications were stopped. No episodes of sustained VT leading to ICD shocks were observed for the following 9 months. The events in this case suggest that dual site LV pacing with biventricular pacing could be an alternative strategy for the management of refractory VT.
authors.affiliation: Library, Trinity Medical Center, 2701 17th St., Rock Island, IL 61201, USA.
authors.forename: Helbert
authors.initials: H
authors.lastname: Acosta
authors.forename: Vijayasimha R
authors.initials: VR
authors.lastname: Pothula
authors.forename: John
authors.initials: J
authors.lastname: Arter
authors.forename: Cindy
authors.initials: C
authors.lastname: Antonio
authors.forename: Sumati
authors.initials: S
authors.lastname: Ramadas
authors.forename: Agustin
authors.initials: A
authors.lastname: Castellanos
mesh_terms: D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D009202:Cardiomyopathies / Q000175:diagnosis / Q000628:therapy*; D002908:Chronic Disease; D006801:Humans; D008297:Male; D012008:Recurrence; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000517:prevention & control*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000517:prevention & control*