Key result
Slow VT below ICD detection threshold triggers atypical atrial pacing via a rate-smoothing algorithm.
Population
A 78-year-old man with nonischemic cardiomyopathy, incessant VT, and an ICD presenting with recurrent syncope
Design
Case report
Authors
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Case of recurrent syncope despite ICD in advanced NICM; leaves open optimal ablation and programming strategies.
Case Report (n=1)
This case demonstrates that manufacturer-specific rate-smoothing algorithms in dual-chamber ICDs can cause atypical atrial pacing during slow ventricular tachycardia.
Yang et al. (2020) conducted a case report in Nonischemic cardiomyopathy and incessant ventricular tachycardia (n=1). Dual-chamber implantable cardioverter-defibrillator (ICD) was evaluated. In a 78-year-old man with an ICD, slow ventricular tachycardia below the detection threshold caused atypical device behavior including atrial pacing due to a rate-smoothing algorithm.