title: Implantable cardioverter defibrillator: charge saver, not syncope saver!
abstract: In patients with an implantable cardioverter defibrillator, empirical antitachycardia pacing/burst pacing (ATP) is associated with a significantly decreased rate of appropriate shocks. The use of ATP as first-line therapy in ventricular tachycardia promotes less pain and better quality of life because the number of shocks is reduced. Additionally, battery longevity is substantially increased with this strategy. Based on this, device manufacturers have developed new algorithms to optimize the use of ATP and shocks in patients with an implantable cardioverter defibrillator. The present report describes a case in which the use of one of these new algorithms was associated with a significant delay in tachycardia termination and, consequently, led to syncope.
authors.affiliation: The Hull Family Cardiac Fibrillation Management Laboratory, Toronto General Hospital, Toronto, Ontario.
authors.forename: Diego
authors.initials: D
authors.lastname: Chemello
authors.forename: Anandaraja
authors.initials: A
authors.lastname: Subramanian
authors.forename: Sheila
authors.initials: S
authors.lastname: Watkins
authors.forename: Krishnakumar
authors.initials: K
authors.lastname: Nair
authors.forename: Kumaraswamy
authors.initials: K
authors.lastname: Nanthakumar
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology; D002304:Cardiac Pacing, Artificial; D017147:Defibrillators, Implantable; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications; D011788:Quality of Life; D013575:Syncope / Q000209:etiology*; D017180:Tachycardia, Ventricular / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control*; D016896:Treatment Outcome