Initiation of ventricular tachycardia by interruption of pacemaker-mediated tachycardia in a patient with a dual-chamber implantable cardioverter defibrillator.
A 74-year-old man with a dual-chamber implantable cardioverter defibrillator implanted 3 years before experienced multiple ventricular tachycardias (VTs). All episodes were initiated by pacemaker-mediated tachycardia (PMT) that was either stopped by atrial undersensing or the tachycardia termination algorithm of the device. After the termination of PMT, two rapid ventricular paced beats, the first initiated by artificial triggering and the second due to retrograde conduction of the first one, initiated VT that was successfully terminated by antitachycardia pacing or a direct current shock of the device. All episodes revealed this pattern of initiation with a short-long-short ventricular sequence inducing VT.
Van Gelder
Berry M
BM
Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands.
Meijer
Albert
A
Dekker
Lukas R
LR
Bracke
Frank A
FA
D000368:Aged; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004868:Equipment Failure; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D017180:Tachycardia, Ventricular / Q000209:etiology* / Q000517:prevention & control*