Case 3 A Diverted Defibrillator Shock

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Patient: 54-year-old female with ischemic heart disease, old anterior wall myocardial infarction.

Index arrhythmia: out-of-hospital arrest, ventricular fibrillation.

Observation: diverted defibrillator shock.

Electrogram

Figure 6.3a. Stored wide-band (shock) electrogram.

ICD pulse generator: Ventak Mini IV (Guidant Inc, St Paul, MN, USA).

Tachycardia settings

Detection: VF = 270 ms; VT = 315 ms. Discrimination: onset = 16%; stability = 30 ms.

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

Bradycardia settings Mode: VVI 40bpm.

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