Pacemaker-mediated tachycardia in a dual-lead CRT-D: What is the mechanism?
TriVentricular
cardiac resynchronisation therapy
dual left ventricular lead
heart failure exacerbation
pacemaker-mediated tachycardia
Journal
Pacing and clinical electrophysiology : PACE
ISSN: 1540-8159
Titre abrégé: Pacing Clin Electrophysiol
Pays: United States
ID NLM: 7803944
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
01
06
2020
revised:
20
09
2020
accepted:
11
10
2020
pubmed:
16
10
2020
medline:
20
11
2021
entrez:
15
10
2020
Statut:
ppublish
Résumé
A 73-year-old gentleman with dilated cardiomyopathy, left bundle branch block and a left ventricular (LV) ejection fraction of 20% was implanted with two LV leads in a tri-ventricular cardiac resynchronisation therapy defibrillator (CRT-D) trial. As a part of the trial he was programmed with fusion-based CRT therapy with dual LV lead only pacing. The patient presented to local heart failure service 12 years after implant, after a positive response to CRT therapy, with increase in fatigue, shortness of breath and bilateral pitting oedema. The patient sent a remote monitoring transmission that suggested loss of capture on one of the LV leads. This coupled with atrial ectopics was producing a high burden of pacemaker-mediated tachycardia (PMT) that was not seen when both LV leads had been capturing. What is the mechanism for this? Dual LV-lead tri-ventricular leads have been shown to have variable improvements in CRT response but with an increased complexity of implant procedure. This is the first case report of PMT-induced heart failure exacerbation in a tri-ventricular device following loss of LV capture of one lead.
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
151-155Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
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