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Figure 1.3. Interval table (Medtronic PCD 7219). After a rather long interval of 470 ms, and a much shorter coupling of 370 ms, a more or less regular tachycardia becomes present with cycle length of 250 to 300 ms. After these intervals the device reports that ventricular fibrillation (VF) was detected.

ascertainment of electrocardiogram features. It is thought that devices with accurate atrial information will be extremely helpful.

Stored electrograms have increased our understanding of events leading to ventricular tachycardia, ventricular fibrillation, or sudden death, also in exceptional occasions or syndromes [7-14]. In this book, we will try to draw the attention of the reader also to these features.

Figure 1.4. Electrogram recorded via wand and ECG machine (Guidant, Ventak 1625). With alternating current, a polymorphic wide QRS arrhythmia is induced with smaller amplitude than the preceding rhythm. After a shock (lower strip, upward spike) the amplifier is saturated, initially resulting in lower amplitudes of restored normal sinus rhythm.

Figure 1.4. Electrogram recorded via wand and ECG machine (Guidant, Ventak 1625). With alternating current, a polymorphic wide QRS arrhythmia is induced with smaller amplitude than the preceding rhythm. After a shock (lower strip, upward spike) the amplifier is saturated, initially resulting in lower amplitudes of restored normal sinus rhythm.

References

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13. Kakishita M, Kurita T, Matsuo K, Taguchi A, Suyama K, Shimizu W, Aihara N, Kamakura S, Yamamoto F, Kobayashi J, Kosakai Y, Ohe T. Mode of onset of ventricular fibrillation in patients with Brugada syndrome detected by implantable cardioverter defibrillator therapy. J Am Coll Cardiol 2000;36:1646-1653.

14. Schimpf R, Wolpert C, Bianchi F, Giustetto C, Gaita F, Bauersfeld U, Borggrefe M. Congenital short QT syndrome and implantable cardioverter defibrillator treatment: inherent risk for inappropriate shock delivery. J Cardiovasc Electro-physiol 2003;14:1273-1277.

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