title: Extended bipolar left ventricular pacing as a possible therapy for late electrical storm induced by cardiac resynchronization therapy.
abstract: Although cardiac resynchronization therapy (CRT) has become a well-established treatment option for patients with drug-refractory severe systolic heart failure, there has been some evidence of adverse proarrhythmic events. We report a case of a patient with ischemic cardiomyopathy who underwent CRT with a defibrillator for primary prevention of sudden cardiac death. Two years after the implantation, the patient presented with electrical storm, which was completely terminated by modifying the left ventricular (LV) pacing configuration from true to extended bipolar LV pacing. We discuss the possible pathophysiologic mechanisms of this phenomenon through a brief review of the literature on CRT-induced proarrhythmia.
authors.affiliation: Department of Cardiology, Royal Bournemouth Hospital, United Kingdom. Electronic address: dimasvestas@gmail.com.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Asvestas
authors.affiliation: Department of Cardiology, Royal Bournemouth Hospital, United Kingdom.
authors.forename: Richard
authors.initials: R
authors.lastname: Balasubramaniam
authors.affiliation: Department of Cardiology, Royal Bournemouth Hospital, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Sopher
authors.affiliation: Department of Cardiology, Royal Bournemouth Hospital, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Paisey
authors.affiliation: Department of Cardiology, Royal Bournemouth Hospital, United Kingdom.
authors.forename: Girish G
authors.initials: GG
authors.lastname: Babu
mesh_terms: D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D006801:Humans; D008297:Male; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome
keywords: CRT; Proarrhythmia; VT storm