Ventricular electrical storm after Micra™ leadless pacemaker implant

Peri- and post-procedural ventricular tachycardia (VT) is a rare complication after leadless pacemaker implantation and requires an individualized approach. In this case report we describe the management of VT in a patient with subendocardial scarring due to prior coronary artery disease who present...

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Bibliographic Details
Published in:Journal of electrocardiology 2021-07, Vol.67, p.110-114
Main Authors: Vandenberk, Bert, Lee, William, Veenhuyzen, George, Sumner, Glen, Kuriachan, Vikas, Quinn, Russell F.
Format: Article
Language:English
Subjects:
Cardiac ablation
Cardiac arrhythmia
Cardiomyopathy
Cardiovascular disease
Complication
Leadless pacemaker
Pacemakers
Transplants & implants
Ventricular electrical storm
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Summary:Peri- and post-procedural ventricular tachycardia (VT) is a rare complication after leadless pacemaker implantation and requires an individualized approach. In this case report we describe the management of VT in a patient with subendocardial scarring due to prior coronary artery disease who presented with monomorphic VT the day after implant. The etiology was found to be related to the novel ventricular activation wavefront by ventricular pacing which induced a reentrant circuit dependent on pre-existing myocardial substrate. Invasive electrophysiologic study and ablation is a safe and successful treatment strategy in selected patients with evidence of myocardial scarring.
ISSN:0022-0736
1532-8430
DOI:10.1016/j.jelectrocard.2021.06.002