Short-long-short sequence caused by ventricular safety pacing inducing ventricular tachycardia in a patient with a dual-chamber implantable cardioverter defibrillator.
Ventricular safety pacing (VSP) is an algorithm used to prevent crosstalk inhibition and ventricular capture during the vulnerable period. We report a 78-year-old man with implantable dual-chamber defibrillator, in whom clusters of ventricular tachycardias (VTs) were provoked by the VSP. During rapid DDDR pacing, the delivery of the VSP after every other atrial-paced beat resulted in short-long-short ventricular sequences and induced VTs. An atrial-based lower rate timing, long atrioventricular pacing interval, and automatic gain control also accounted for this arrhythmogenic ventricular sequence. The VSP and the subsequent VT were eliminated by decreasing the pacing rate.
Hayashi
Meiso
M
Cardiology Department, Lariboisière Hospital, Paris 7 University, 2 Rue Ambroise Paré, 75475 Paris Cedex 10, France.
Takatsuki
Seiji
S
Messali
Anne
A
Milliez
Paul
P
Extramiana
Fabrice
F
Leenhardt
Antoine
A
D000368:Aged; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004868:Equipment Failure; D019544:Equipment Failure Analysis; D004869:Equipment Safety; D006801:Humans; D008297:Male; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000209:etiology* / Q000517:prevention & control*