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Journal of Rare Cardiovascular Diseases
ISSN: 2299-3711 (Print)
e-ISSN: 2300-5505 (Online)
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Patient with multiple ICD interventions (RCD code: V‑2A.O)
Piotr Liszniański
,  
Piotr Nowak
,  
Piotr Stryjewski
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Abstract
The authors report a case of a 58-year-old man with coronary artery disease and left ventricular aneurysm following inferior wall infarc tion, who was implanted with a single chamber cardioverter-defibrillator (ICD) for primary prevention of sudden cardiac death. The pa tient presented with complaints including multiple ICD shocks due to recurrent ventricular tachycardia (VT) resistant to the implement ed treatment, decreased quality of life and high level of anxiety associated with multiple hospitalizations. Pharmacological treatment was unsuccessful and led to drug-induced bradycardia. Due to developed pacemaker syndrome the patient underwent ICD upgrade to a dual-chamber device followed by radiofrequency ablation. Despite a number of interventions, VT did not completely disappear. A slight decrease in the number of ICD shocks was observed. After adjustment of the pacing lower rate up to 75 bpm, ventricular arrhyth mias were reduced and eventually retreated. In the six months follow-up period no VT was recorded. The authors discuss the current recommendations for VT treatment with the indications for re-ablation or aneurysmectomy
Keywords
rare disease, ventricular tachycardia, ventricular aneurysm, pacemaker syndrome, ablation
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Keywords
Classification of Rare Cardiovascular Diseases anticoagulation atrial fibrillation atrial septal defect cardiomyopathy computed tomography congenital heart disease echocardiography electrocardiogram electrocardiography heart failure implantable cardioverter‑defibrillator magnetic resonance imaging pregnancy pulmonary arterial hypertension pulmonary hypertension rare cardiovascular disease rare disease right heart catheterization right ventricular failure
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