Case 39 Widecomplex Tachycardia

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Patient: 53-year-old male with ischemic heart disease, old myocardial infarction, left ventricular ejection fraction 30%, and QRS width 108 ms.

Index arrhythmia: non-sustained ventricular tachycardia, cycle length 330 ms.

Complaint: palpitations.

Interval plot

Figure 6.39a.

ICD pulse generator: Marquis VR 7250 (Medtronic Inc, Minneapolis, MN, USA).

Tachycardia settings

Detection: VF = 330 ms; FVT = 240 ms; VT = 430 ms. Discrimination: onset = 88%; stability = 40 ms; wavelet = ON, 70%. Therapy: VF = shock; FVT = antitachycardia pacing and cardioversion; VT = monitor.

Bradycardia settings VVI: 40bpm.

Electrogram (See Figure 6.39b) Interpretation

1. Presence of tachyarrhythmia?: Yes.

2. Assessment of the onset of the tachyarrhythmia triggering the device: a premature beat (1) initiates a fast tachyarrhythmia (2).

Marker Annotation. V-V Interval (ms) :

Marker Annotation. V-V Interval (ms) :

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