Key result
High-voltage ICD shock triggers atrioventricular-reentrant tachycardia in a patient with HCM.
Why the study?
Induction of atrioventricular reentrant tachycardia by high-voltage implantable cardioverter defibrillator shock in hypertrophic cardiomyopathy had not been previously reported.
Case Report (n=1)
High-voltage shocks may induce AVRT degenerating to VF in HCM with oversensing; hypothesis-generating for device proarrhythmia.
A 23-year-old woman with obstructive hypertrophic cardiomyopathy and history of frequent unexplained syncope had undergone implantable cardioverter defibrillator implantation. She had experienced frequent inappropriate shocks since implantation due to T-wave oversensing. After one of the syncopal attacks, she was found to have an atrioventricular (AV)-reentrant tachycardia, induced by a high-voltage shock, with rapid degeneration to atrial fibrillation and then ventricular fibrillation. The AV-reentrant tachycardia was believed to be the cause of both syncopal attacks and inappropriate shocks. The patient has been asymptomatic after ablation of the accessory pathway. To the best of our knowledge, this is the first report of induction of an AV-reentrant tachycardia by a high-voltage implantable cardioverter defibrillator shock.
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Akbarzadeh et al. (2009) conducted a case report in Obstructive hypertrophic cardiomyopathy (n=1). High-voltage implantable cardioverter defibrillator shock was evaluated on Induction of atrioventricular-reentrant tachycardia. A high-voltage implantable cardioverter defibrillator shock induced an atrioventricular-reentrant tachycardia in a patient with hypertrophic cardiomyopathy.
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