Key result
Transvenous left ventricular pacing lead placement during biventricular ICD upgrade led to exacerbation of monomorphic ventricular tachycardia in 1 patient, which was controlled with pharmacotherapy.
Why the study?
Does transvenous left ventricular pacing lead placement during biventricular upgrade exacerbate monomorphic ventricular tachycardia?
Case Report (n=1)
No
Does transvenous left ventricular pacing lead placement during biventricular upgrade exacerbate monomorphic ventricular tachycardia?
Biventricular ICD upgrade with transvenous left ventricular pacing lead placement can potentially exacerbate monomorphic ventricular tachycardia, which may be managed with pharmacotherapy.
Answers are grounded in this paper and cite their sources.
Potential VT exacerbation during BiV ICD upgrade warrants caution in lead placement; leaves open incidence and predictors.
We report the case of a patient in whom transvenous left ventricular pacing lead placement at the time of a biventricular upgrade led to an exacerbation of clinical monomorphic ventricular tachycardia (MVT). At implant, slow left ventricular pacing repeatedly induced sustained MVT. However, testing of the biventricular pacing showed no MVT inducibility, and the system was implanted. The patient was readmitted due to multiple episodes of the MVT observed at implant. The MVT was controlled with pharmacotherapy, allowing the patient to continue with biventricular pacing.
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Palmero et al. (2003) conducted a case report in Monomorphic ventricular tachycardia (n=1). Biventricular implantable cardioverter defibrillator upgrade was evaluated on Exacerbation of clinical monomorphic ventricular tachycardia. Transvenous left ventricular pacing lead placement during biventricular ICD upgrade led to exacerbation of monomorphic ventricular tachycardia in 1 patient, which was controlled with pharmacotherapy.
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