Pseudo crosstalk behavior in a patient with atrio-ventricular block and implanted biventricular defibrillator.
We present a 59-year-old man with a dilated cardiomyopathy (ejection fraction = 20%), congestive heart failure and atrio-ventricular (AV) block who underwent implantation of a biventricular defibrillator (BiV ICD). While undergoing cardiac transplant evaluation for drug-refractory ventricular fibrillation, his telemetry recorded findings resembling crosstalk inhibition. Device interrogation was normal. All episodes occurred at 1:00 a.m. suggesting a routine device operation. Left ventricular capture management, a new feature that automatically measures left ventricular pacing thresholds at 1:00 a.m., had been programmed to Monitor. Understanding this sophisticated pacing algorithm might avoid confusion when operative in patients with AV block.
Ho
Reginald T
RT
Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA. reginald.ho@jefferson.edu
Mark
George E
GE
Rhim
Eugene S
ES
Shorrock
Susan M
SM
D000465:Algorithms; D001283:Atrioventricular Node / Q000503:physiopathology*; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology / Q000628:therapy; D017147:Defibrillators, Implantable; D004868:Equipment Failure; D006327:Heart Block / Q000503:physiopathology* / Q000628:therapy*; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D013686:Telemetry