[HTML][HTML] Intrinsic anti-tachycardia pacing terminated ventricular tachycardia resistant to traditional anti-tachycardia pacing

H Hagiwara, M Watanabe, R Kamada… - Indian Pacing and …, 2022 - Elsevier
H Hagiwara, M Watanabe, R Kamada, T Anzai
Indian Pacing and Electrophysiology Journal, 2022Elsevier
Implantable cardioverter-defibrillators (ICDs) serve to reduce the risk of sudden death;
however, ICD shocks worsen patient prognosis. Therefore, attempts have been made to
terminate life-threatening arrhythmias without ICD shocks. A 71-year-old man with non-
ischemic cardiomyopathy, who previously underwent cardiac resynchronization therapy-
defibrillator (CRT-D) placement, was hospitalized for ventricular tachyarrhythmia (VT) that
was refractory to traditional anti-tachycardia pacing (ATP). Endocardial and epicardial …
Abstract
Implantable cardioverter-defibrillators (ICDs) serve to reduce the risk of sudden death; however, ICD shocks worsen patient prognosis. Therefore, attempts have been made to terminate life-threatening arrhythmias without ICD shocks. A 71-year-old man with non-ischemic cardiomyopathy, who previously underwent cardiac resynchronization therapy-defibrillator (CRT-D) placement, was hospitalized for ventricular tachyarrhythmia (VT) that was refractory to traditional anti-tachycardia pacing (ATP). Endocardial and epicardial ablation failed to prevent VT recurrence. Since the CRT-D battery was exhausted, it was replaced with a Cobalt™ XT HF CRT-D (Medtronic, Minneapolis, MN, USA), and the intrinsic ATP (iATP) algorithm was employed. Although VT recurred frequently, recurrent VTs were terminated by the iATP, which created a conduction block in the circuit without VT acceleration or shock. This is the first reported case wherein an iATP algorithm was effective against VT resistant to traditional anti-tachycardia pacing. This novel ATP algorithm has the potential to terminate refractory VT without ICD shocks and provide a better prognosis.
Elsevier
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