Frequent recurrent polymorphic ventricular tachycardia during sleep due to managed ventricular pacing.
We report a case of a patient with an implantable cardioverter defibrillator and no prior history of heart block with managed ventricular pacing (MVP) programmed who had frequent recurrent episodes of polymorphic ventricular tachycardia. All of the episodes were initiated by transient atrioventricular block which resulted in short-long-short sequences permitted by MVP. This case illustrates that MVP should be used with caution not only in patients with complete heart block, but also in patients at risk for brief heart block due to such states as hypervagatonia due to sleep apnea.
Vavasis
Christos
C
Department of Cardiology, Long Island Jewish Medical Center, New Hyde Park, New York, USA.
Slotwiner
David J
DJ
Goldner
Bruce G
BG
Cheung
Jim W
JW
D054537:Atrioventricular Block / Q000209:etiology / Q000503:physiopathology*; D002304:Cardiac Pacing, Artificial; D017147:Defibrillators, Implantable; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology*; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000503:physiopathology*; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000209:etiology / Q000503:physiopathology