Successful Treatment of Ventricular Fibrillation Storm Triggered by Short-Long-Short Sequence; Time to Avoid Managed Ventricular Pacing

Abstract Sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM) is caused by ventricular tachyarrhythmia that can be effectively treated by implantable cardioverter defibrillator (ICD) therapy. We report of a 28-year-old man with HCM and a dual chamber ICD, originally implanted for primary...

Full description

Saved in:
Bibliographic Details
Published in:Journal of electrocardiology 2017-11, Vol.50 (6), p.941-943
Main Authors: Alnsasra, Hilmi, MD, Konstantino, Yuval, MD, Bereza, Sergiy, MD, Haim, Moti, MD
Format: Article
Language:English
Subjects:
Adult
Cardiac arrhythmia
Cardiac Pacing, Artificial - methods
Cardiomyopathy
Cardiomyopathy, Hypertrophic - physiopathology
Cardiomyopathy, Hypertrophic - therapy
Cardiovascular
Death, Sudden, Cardiac - prevention & control
Electrocardiography
Humans
Male
Managed ventricular pacing
Pacemaker, Artificial
Short-long-short
Ventricular fibrillation
Ventricular Fibrillation - physiopathology
Ventricular Fibrillation - therapy
Ventricular rate stabilization
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM) is caused by ventricular tachyarrhythmia that can be effectively treated by implantable cardioverter defibrillator (ICD) therapy. We report of a 28-year-old man with HCM and a dual chamber ICD, originally implanted for primary prevention of SCD, (programmed to AAI(R)-DDD(R) ; managed ventricular pacing (MVP) mode ,Medtronic Inc. St Paul, MN USA). He presented with recurrent ICD shocks due to ventricular fibrillation (VF) despite antiarrhythmic therapy. Careful assessment of the stored electrograms demonstrated a repetitive pattern of VF initiation following short-long-short sequences. Initially, activation of ventricular rate stabilization (VRS) algorithm failed to prevent recurrent VF. Ultimately, deactivation of MVP and reprogramming the device to DDD mode with VRS on, resulted in arrhythmia suppression and avoidance of ICD shocks. Physicians should be aware that although VRS function is available in MVP mode, it does not function in the AAI mode during MVP; in order to effectively treat short-long-short sequence induced ventricular arrhythmia by device programming.
ISSN:0022-0736
1532-8430
DOI:10.1016/j.jelectrocard.2017.06.005