Key result
Reprogramming an implantable cardioverter-defibrillator from DDD to VVI mode prevented recurrent ventricular arrhythmias caused by an intradevice timing interaction.
Why the study?
ICDs intended to prevent malignant arrhythmias can, in rare cases, precipitate them.
Does reprogramming an ICD from DDD to VVI mode prevent device-induced arrhythmias in a patient with masked PVCs?
Case Report (n=1)
Does reprogramming an ICD from DDD to VVI mode prevent device-induced arrhythmias in a patient with masked PVCs?
This case highlights the importance of individualized ICD programming to avoid device-induced arrhythmias caused by masked PVCs.
Supports individualized ICD programming in rare device-induced arrhythmia cases; leaves broader applicability open pending prospective data.
An implantable cardioverter-defibrillator (ICD) intended to prevent malignant arrhythmias can, in rare cases, precipitate them. We report a 44-year-old man with cardiac sarcoidosis who suffered recurrent polymorphic ventricular tachycardia (VT) and ventricular fibrillation (VF) due to an intradevice timing interaction. Premature ventricular contractions (PVCs) fell within the ICD's post-atrial pacing ventricular blanking period and went undetected ("masked"), resulting in ventricular pacing during the vulnerable period (R-on-T), which triggered VT/VF. Reprogramming the device from DDD to VVI mode prevented further arrhythmias. This case highlights the importance of individualized ICD programming to avoid device-induced arrhythmias.
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Vignarajah et al. (2025) conducted a case report in Cardiac sarcoidosis with recurrent ventricular arrhythmias (n=1). Reprogramming ICD from DDD to VVI mode was evaluated on Prevention of further arrhythmias. Reprogramming an implantable cardioverter-defibrillator from DDD to VVI mode prevented recurrent ventricular arrhythmias caused by an intradevice timing interaction.
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