Case 13 Regular Tachycardia 150 Beats Per Minute

Patient: 67-year-old male with ischemic heart disease, coronary artery bypass grafting.

Index arrhythmia: sustained monomorphic ventricular tachycardia.

Complaint: palpitations.

Electrogram

3 s 2 I 3 I I § I I § I I I I I I § I Figure 6.13a. From top to bottom: wide-band electrogram, markers, and device activity channel.

ICD pulse generator: Defender IV DR 612 (ELA Medical, Le Plessis, France). Tachycardia settings

Detection: VF = 300 ms; fast VT via VF = 270 ms; VT = 430 ms. Discrimination: stability = 40 ms; PR Logic ON.

Therapy: VF = shock; fast VT and VT = antitachycardia pacing and cardioversion.

Bradycardia settings Mode: DDD 70-120 bpm. Mode switch = ON. AV = 110 ms.

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