Rate smoothing induced ventricular arrhythmia and syncope: a new device-induced proarrhythmia.
A 74-year-old male presented to our emergency room with history of sudden onset palpitations associated with syncope. He had a single-chamber implantable cardioverter defibrillator implanted for secondary prevention of sudden cardiac death due to ischaemic cardiomyopathy. Interrogation of the device revealed episodes of non-sustained ventricular tachycardia (NSVT) at 220 ms. Post-tachycardia, another episode of NSVT with longer duration, was induced by rate smoothing pacing algorithm following premature ventricular beats. We describe this unique form of device-related proarrhythmia causing syncope.
Mulpuru
Siva K
SK
Cardiovascular Diseases, Beth Israel Medical Center, 1st Avenue at 16th Street, New York, NY 10003, USA. osmecan2000@yahoo.com
Fujita
Hiroshi
H
Saponieri
Cesare
C
D000368:Aged; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D011475:Prosthesis Failure; D013575:Syncope / Q000175:diagnosis* / Q000209:etiology*; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000209:etiology*