Ventricular tachycardia induced by pacing algorithm designed to avoid atrial fibrillation |
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Institution: | Serviço de Cardiologia, Hospital Professor Doutor Fernando da Fonseca, EPE, Amadora, Portugal |
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Abstract: | A patient with a dual chamber pacemaker was admitted to the emergency room after out-of-hospital cardioversion for syncopal sustained monomorphic ventricular tachycardia. Device interrogation revealed an abnormally timed ventricular spike after a ventricular premature beat at the beginning of the event, caused by a pacemaker algorithm designed to avoid atrial fibrillation, non-competitive atrial pacing. Despite the absence of significant coronary lesions, in the setting of a vulnerable substrate – a hypokinetic and hyperechogenic region of ventricular myocardium – an upgrade to a dual-chamber implantable cardioverter-defibrillator was performed, and substrate ablation was planned. |
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Keywords: | Ventricular tachycardia Pacemaker algorithm Non-competitive atrial pacing Taquicardia ventricular |
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