title: [Non-invasive electrophysiologic study and radiofrequency current ablation of tachycardia responsible for numerous inappropriate ICD interventions in patient with post-infarction dilated cardiomyopathy].
abstract: 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.
authors.affiliation: Pracownia Elektroterapii Serca, Oddział Kardiologii, Wojewódzki Szpital Specjalistyczny, Ośrodek Badawczo-Rozwojowy, Wrocław. mroczeke@wp.pl
authors.forename: Ewa
authors.initials: E
authors.lastname: Mroczek
authors.forename: Bartosz
authors.initials: B
authors.lastname: Ludwik
authors.forename: Mariusz
authors.initials: M
authors.lastname: Mazij
authors.forename: Michał
authors.initials: M
authors.lastname: Labus
authors.forename: Sebastian
authors.initials: S
authors.lastname: Stec
authors.forename: Janusz
authors.initials: J
authors.lastname: Sledź
authors.forename: Jerzy
authors.initials: J
authors.lastname: Spikowski
authors.forename: Jerzy
authors.initials: J
authors.lastname: Lewczuk
mesh_terms: 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