Case 5 Assessment After Syncope
Patient: 80-year-old male with ischemic heart disease, coronary artery bypass grafting, left ventricular ejection fraction <0.35, and permanent atrial fibrillation.
Index arrhythmia: non-sustained ventricular tachycardias. Complaint: Syncope.
Electrogram (Two continuous strips are shown).
- Figure 6.5a. From top to bottom: far-field ventricular electrogram, near-field ventricular electrogram, and marker channel. Markers: FD = fibrillation detected; FS = fibrillation sensing; TF: fast tachycardia sensing; TS = tachycardia sensing.
ICD pulse generator: Gem VR 7221 (Medtronic Inc, Minneapolis, MN, USA). Tachycardia settings
Detection: VF = 300 ms; fast VT via VF = 260 ms; VT = 370 ms.
Discrimination: stability = 30 ms.
Therapy: VF = shock; fast VT and VT = antitachycardia pacing and cardioversion.
Mode: VVIR 60-120 bpm.
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