Anti-tachycardia pacing degenerated fast ventricular tachycardia into undetectable life-threatening tachyarrhythmia in a patient with non-ischemic dilated cardiomyopathy

Kei Yunoki, Nobuhiro Nishii, Hiroshi Morita, Jun Iwasaki, Satoshi Nagase, Kazufumi Nakamura, Yoshiki Hata, Kunihisa Kohno, Kengo F. Kusano, Hiroshi Itoh

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

A 45-year-old man with dilated cardiomyopathy was admitted to our hospital due to congestive heart failure (CHF). Despite the optimal medical treatment, his condition had not improved because of severe left ventricular dysfunction. Because he experienced non-sustained ventricular tachycardia (VT), a biventricular implantable cardioverter-defibrillator (Bi-V ICD) was implanted for reduction of dyssynchrony and primary prevention of lethal tachyarrhythmia. After discharge, he developed CHF and was transported to our hospital by ambulance. In the ambulance, monomorphic sustained VT with 200. bpm suddenly occurred. The ICD detected it as fast VT and anti-tachycardia pacing (ATP) was delivered. After the ATP therapy, RR intervals of VT became irregular and prolonged. Ventricular fibrillation-like electrical activity was recorded by a far-field electrogram from the defibrillator, but the tachycardia cycle length exceeded 400. ms which is under the tachycardia detection rate. The device failed to deliver a shock and the patient had to be rescued with an external shock. This is a rare case of fast VT that degenerated into undetectable life-threatening tachyarrhythmia by ATP.

Original languageEnglish
JournalJournal of Cardiology Cases
Volume2
Issue number3
DOIs
Publication statusPublished - Dec 2010

Fingerprint

Dilated Cardiomyopathy
Ventricular Tachycardia
Tachycardia
Ambulances
Shock
Heart Failure
Defibrillators
Implantable Defibrillators
Left Ventricular Dysfunction
Ventricular Fibrillation
Primary Prevention
Equipment and Supplies
Therapeutics

Keywords

  • Anti-tachycardia pacing
  • Implantable cardioverter-defibrillator
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Anti-tachycardia pacing degenerated fast ventricular tachycardia into undetectable life-threatening tachyarrhythmia in a patient with non-ischemic dilated cardiomyopathy. / Yunoki, Kei; Nishii, Nobuhiro; Morita, Hiroshi; Iwasaki, Jun; Nagase, Satoshi; Nakamura, Kazufumi; Hata, Yoshiki; Kohno, Kunihisa; Kusano, Kengo F.; Itoh, Hiroshi.

In: Journal of Cardiology Cases, Vol. 2, No. 3, 12.2010.

Research output: Contribution to journalArticle

@article{8eba8e2345414955b84247c2e831956a,
title = "Anti-tachycardia pacing degenerated fast ventricular tachycardia into undetectable life-threatening tachyarrhythmia in a patient with non-ischemic dilated cardiomyopathy",
abstract = "A 45-year-old man with dilated cardiomyopathy was admitted to our hospital due to congestive heart failure (CHF). Despite the optimal medical treatment, his condition had not improved because of severe left ventricular dysfunction. Because he experienced non-sustained ventricular tachycardia (VT), a biventricular implantable cardioverter-defibrillator (Bi-V ICD) was implanted for reduction of dyssynchrony and primary prevention of lethal tachyarrhythmia. After discharge, he developed CHF and was transported to our hospital by ambulance. In the ambulance, monomorphic sustained VT with 200. bpm suddenly occurred. The ICD detected it as fast VT and anti-tachycardia pacing (ATP) was delivered. After the ATP therapy, RR intervals of VT became irregular and prolonged. Ventricular fibrillation-like electrical activity was recorded by a far-field electrogram from the defibrillator, but the tachycardia cycle length exceeded 400. ms which is under the tachycardia detection rate. The device failed to deliver a shock and the patient had to be rescued with an external shock. This is a rare case of fast VT that degenerated into undetectable life-threatening tachyarrhythmia by ATP.",
keywords = "Anti-tachycardia pacing, Implantable cardioverter-defibrillator, Ventricular tachycardia",
author = "Kei Yunoki and Nobuhiro Nishii and Hiroshi Morita and Jun Iwasaki and Satoshi Nagase and Kazufumi Nakamura and Yoshiki Hata and Kunihisa Kohno and Kusano, {Kengo F.} and Hiroshi Itoh",
year = "2010",
month = "12",
doi = "10.1016/j.jccase.2010.06.003",
language = "English",
volume = "2",
journal = "Journal of Cardiology Cases",
issn = "1878-5409",
publisher = "Elsevier Limited",
number = "3",

}

TY - JOUR

T1 - Anti-tachycardia pacing degenerated fast ventricular tachycardia into undetectable life-threatening tachyarrhythmia in a patient with non-ischemic dilated cardiomyopathy

AU - Yunoki, Kei

AU - Nishii, Nobuhiro

AU - Morita, Hiroshi

AU - Iwasaki, Jun

AU - Nagase, Satoshi

AU - Nakamura, Kazufumi

AU - Hata, Yoshiki

AU - Kohno, Kunihisa

AU - Kusano, Kengo F.

AU - Itoh, Hiroshi

PY - 2010/12

Y1 - 2010/12

N2 - A 45-year-old man with dilated cardiomyopathy was admitted to our hospital due to congestive heart failure (CHF). Despite the optimal medical treatment, his condition had not improved because of severe left ventricular dysfunction. Because he experienced non-sustained ventricular tachycardia (VT), a biventricular implantable cardioverter-defibrillator (Bi-V ICD) was implanted for reduction of dyssynchrony and primary prevention of lethal tachyarrhythmia. After discharge, he developed CHF and was transported to our hospital by ambulance. In the ambulance, monomorphic sustained VT with 200. bpm suddenly occurred. The ICD detected it as fast VT and anti-tachycardia pacing (ATP) was delivered. After the ATP therapy, RR intervals of VT became irregular and prolonged. Ventricular fibrillation-like electrical activity was recorded by a far-field electrogram from the defibrillator, but the tachycardia cycle length exceeded 400. ms which is under the tachycardia detection rate. The device failed to deliver a shock and the patient had to be rescued with an external shock. This is a rare case of fast VT that degenerated into undetectable life-threatening tachyarrhythmia by ATP.

AB - A 45-year-old man with dilated cardiomyopathy was admitted to our hospital due to congestive heart failure (CHF). Despite the optimal medical treatment, his condition had not improved because of severe left ventricular dysfunction. Because he experienced non-sustained ventricular tachycardia (VT), a biventricular implantable cardioverter-defibrillator (Bi-V ICD) was implanted for reduction of dyssynchrony and primary prevention of lethal tachyarrhythmia. After discharge, he developed CHF and was transported to our hospital by ambulance. In the ambulance, monomorphic sustained VT with 200. bpm suddenly occurred. The ICD detected it as fast VT and anti-tachycardia pacing (ATP) was delivered. After the ATP therapy, RR intervals of VT became irregular and prolonged. Ventricular fibrillation-like electrical activity was recorded by a far-field electrogram from the defibrillator, but the tachycardia cycle length exceeded 400. ms which is under the tachycardia detection rate. The device failed to deliver a shock and the patient had to be rescued with an external shock. This is a rare case of fast VT that degenerated into undetectable life-threatening tachyarrhythmia by ATP.

KW - Anti-tachycardia pacing

KW - Implantable cardioverter-defibrillator

KW - Ventricular tachycardia

UR - http://www.scopus.com/inward/record.url?scp=78649633273&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78649633273&partnerID=8YFLogxK

U2 - 10.1016/j.jccase.2010.06.003

DO - 10.1016/j.jccase.2010.06.003

M3 - Article

VL - 2

JO - Journal of Cardiology Cases

JF - Journal of Cardiology Cases

SN - 1878-5409

IS - 3

ER -