Case 7 A Patient with Congenital Heart Disease and Therapies for a Short Arrhythmia

Initiation Strip

Patient 29-year-old male with surgically corrected complex congenital heart disease (double outlet right ventricle malposition of the great arteries, VSD, and coarctation), left ventricular dysfunction, and superior vena cava syndrome, uses salbutamol inhalatorbecause he is asthmatic. QRS width 170 ms. Index arrhythmia sustained monomorphic ventricular tachycardia, cycle length 490 ms. Complaint recurrent palpitations, syncopal, wants to drive. Electrogram (Three continuous strips). ICD pulse...

Case 15 ATP Observed During Routine Control

Wave Oversensing

Patient 74-year-old female with ischemic heart disease, old inferoposterior wall myocardial infarction, left ventricular ejection fraction 0.19, documented paroxysmal atrial fibrillation. Index arrhythmia out-of-hospital cardiac arrest, ventricular fibrillation. Complaint no complaints were noted at follow-up, only events treated with antitachycardia pacing were obtained from the device's memory. 4W 430 422 4W 430 422 Figure 6.15a. From top to bottom marker channel, atrial electrogram, and...

Case 31 Multiple Shocks on the Waiting List for Heart Transplantation

Patient 43-year-old male, with coronary artery disease, heart failure NYHA class III, on the waiting list for heart transplantation. ICD at age 41, recent admission with exacerbation of heart failure, treated with diuretics. Discharged from hospital 2 weeks before the event. Index arrhythmia non-sustained ventricular tachycardia. Complaint six shocks, no palpitations, no chest pain. Figure 6.31a. Electrocardiogram lead II at previous control left and at admission right . No new Q waves, nor ST...

Case 4 Hypokalemia Late After Infarction

Patient 54-year-old female with ischemic heart disease, old anterior wall myocardial infarction. Index arrhythmia out-of-hospital arrest, ventricular fibrillation. Complaint admission one month after implantation because of several consecutive shocks. After defibrillator implantation, pharmacological treatment consisted of 80 mg furosemide, 250 g digoxine, 10 mg fosinopril, and 25 mg spironolacton, in combination with 200 mg amiodarone. ICD pulse generator Ventak Mini IV Guidant Inc, St Paul,...