Successful termination of a ventricular arrhythmia by implantable cardioverter defibrillator therapy in a patient with cardiac amyloidosis: insight into mechanisms of sudden death
Key result
ICD therapy successfully terminates multiple VT and VF episodes in AL cardiac amyloidosis.
- n=1
Why the study?
The precise mechanism of sudden cardiac arrest in patients with AL-type cardiac amyloidosis is not well understood and often attributed to pulseless electrical activity, implying uncertain benefit of ICD therapy.
Does implantable cardioverter defibrillator therapy prevent sudden death from ventricular arrhythmias in patients with AL-type cardiac amyloidosis?
Population
60-year-old male with AL-type cardiac amyloidosis and impaired LV systolic function (EF 20%)
Comparison
ICD therapy vs no ICD therapy (implied)
Design
Case report
Follow-up
3 years
Authors
Discussion
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Member takes
Implication
ICD termination of VT/VF in AL amyloidosis suggests arrhythmias as a sudden-death mechanism; leaves open prophylactic ICD benefit pending prospective data.
Study Design
Type
Case Report (n=1)
Structured PICO
Does implantable cardioverter defibrillator therapy prevent sudden death from ventricular arrhythmias in patients with AL-type cardiac amyloidosis?
P
Population
One 60-year-old male with AL-type cardiac amyloidosis and a prophylactic ICD who presented 3 years post-implantation with multiple ICD firings.
I
Intervention
Implantable cardioverter defibrillator (ICD) therapy
O
Outcome
Termination of ventricular arrhythmias (monomorphic ventricular tachycardia and ventricular fibrillation)hard clinical
This case demonstrates that sustained ventricular arrhythmias can be a mechanism of sudden death in AL-type cardiac amyloidosis and that ICD therapy can successfully terminate these events.
Cite This Study
Lin et al. (2010) conducted a case report in AL-type cardiac amyloidosis (n=1). Implantable cardioverter defibrillator (ICD) was evaluated on Termination of ventricular arrhythmias. Implantable cardioverter defibrillator therapy successfully terminated multiple episodes of ventricular tachycardia and fibrillation in a 60-year-old male with AL-type cardiac amyloidosis.