Key result
Dual-chamber ICD delivers inappropriate shock following spontaneous nonsustained VT termination in complete AV block.
Why the study?
Interaction between bradyarrhythmias and VT/VF in patients with ICDs with dual chamber pacing has not been described and has important clinical implications.
Case Report (n=1)
ICDs with dual chamber pacing capability may deliver inappropriate shocks following spontaneous termination of nonsustained VT in patients with complete AV block.
Answers are grounded in this paper and cite their sources.
Raises caution for inappropriate shocks in dual-chamber ICDs with complete AV block; hypothesis-generating for algorithm refinement.
Transvenous implantable cardioverter defibrillators (ICDs) have improved the management of patients with ventricular tachycardia/ventricular fibrillation (VT/VF). Many patients with sustained VT/VF have bradyarrhythmias and nonsustained VT. Shock delivery due to nonsustained VT would be an undesirable feature. Abortive shock capability (noncommitted shocks) is a feature available in devices to prevent delivery of shocks for nonsustained VT. Recently, the availability of dual chamber pacing capability has improved the efficacy of ICDs by obviating the need of separate pacemaker implantation in patients with VT/VF and concomitant bradyarrhythmias. However, interaction between bradyarrhythmias and VT/VF has not been described and has important clinical implications. We report a case in which a patient with complete atrioventricular (AV) block and ventricular arrhythmias received an inappropriate shock following spontaneous termination of nonsustained VT, showing an important shortcoming of devices with these features.
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Sra et al. (2000) conducted a case report in Complete atrioventricular (AV) block and ventricular arrhythmias (n=1). Implantable cardioverter defibrillator with dual chamber pacing was evaluated on Inappropriate shock delivery. An implantable cardioverter defibrillator with dual chamber pacing delivered an inappropriate shock following spontaneous termination of nonsustained VT in a patient with complete AV block.
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