Key result
Multipoint pacing near scar may prevent CRT-induced polymorphic VT by avoiding unidirectional block and reentry.
Why the study?
Induced proarrhythmia has been reported after cardiac resynchronization therapy, but its underlying mechanism remains under debate.
Does multipoint pacing stimulation prevent CRT-induced polymorphic ventricular tachycardia in a heart failure patient?
Case Report (n=1)
Does multipoint pacing stimulation prevent CRT-induced polymorphic ventricular tachycardia in a heart failure patient?
Multipoint pacing may be an effective strategy to manage and prevent CRT-induced proarrhythmia and electrical storm.
Multipoint pacing near scar may avert CRT-induced polymorphic VT; single case leaves open need for prospective validation.
Although cardiac resynchronization therapy (CRT) reduces morbidity and mortality and reverses left ventricular (LV) remodeling in heart failure patients with LV electrical dyssynchrony, induced proarrhythmia has been reported. The mechanism of CRT-induced proarrhythmia remains under debate. In this case report, a description of how a LV pacing induced polymorphic ventricular tachycardia immediately after the initiation of CRT has been reported. Changing the pacing configuration using a multipoint pacing stimulation, we can assume that VTs induced are related to the reentry mechanism facilitated by the unidirectional block. As a result, MPP pacing configuration near the scar area avoid the onset of a unidirectional block with the establishment of the reentry phenomenon thus avoiding induced VTs.
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Gonella et al. (2024) conducted a case report in Heart failure with LV electrical dyssynchrony (n=1). Multipoint pacing stimulation was evaluated on Prevention of induced ventricular tachycardias. Multipoint pacing stimulation near the scar area avoided the onset of a unidirectional block and reentry phenomenon, thus preventing CRT-induced polymorphic ventricular tachycardia.
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