[Non-invasive electrophysiologic study and radiofrequency current ablation of tachycardia responsible for numerous inappropriate ICD interventions in patient with post-infarction dilated cardiomyopathy].
We present a case of 75-year-old man with numerous inappropriate interventions of an implanted cardioverter-defibrillator (ICD). In this patient with ischaemic cardiomyopathy, ICD was implanted for primary prevention of sudden cardiac death following recurrent syncope. ICD interrogation and non-invasive electrophysiologic study (NIPS) confirmed a risk of reentry-mediated tachycardia and excluded the presence of a manifest or concealed accessory pathway. Invasive electrophysiologic study revealed a wide zone that triggered atrioventricular nodal reentrant tachycardia, and ablation of the slow pathway resulted in complete remission of the arrhythmia. NIPS performed using atrial and ventricular ICD leads and subsequent ICD interrogation confirmed long-term effectiveness of the procedure. At the same time, clinical improvement of heart failure was seen, leading to a suspicion of tachycardia-induced cardiomyopathy coexisting with ischaemic cardiomyopathy.
Mroczek
Ewa
E
Pracownia Elektroterapii Serca, Oddział Kardiologii, Wojewódzki Szpital Specjalistyczny, Ośrodek Badawczo-Rozwojowy, Wrocław. mroczeke@wp.pl
Ludwik
Bartosz
B
Mazij
Mariusz
M
Labus
Michał
M
Stec
Sebastian
S
Sledź
Janusz
J
Spikowski
Jerzy
J
Lewczuk
Jerzy
J
D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D017115:Catheter Ablation / Q000009:adverse effects*; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004562:Electrocardiography; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications*; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome