The clinical impact of untreated slow ventricular tachycardia in patients carrying implantable cardiac defibrillators

Calvo, David; Picazo, Marta; Iglesias, Daniel García; Pérez, Diego; Rubín, José M.; Martínez-Ferrer, José; Rodríguez, Aníbal; Viñolas, Xabier; Alzueta, Javier; Basterra, Nuria; Morı́s, César

doi:10.1007/s10840-020-00877-w

Cited by 1 publication

(2 citation statements)

References 23 publications

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“…The results of the ADVANCE III trial showed that among patients with slow VT detected in the monitor zone, the rate of adverse events was low (5). A recent study suggests that limiting therapies in the slow VT zone to anti-tachycardia pacing (ATP) only will be safe in secondary prevention with slow VT (6). Symptoms will be decisive in such a situation, but if the slow VT is welltolerated, it is postulated that the patient could benefit from avoiding shock therapies (6).…”

Section: Discussionmentioning

confidence: 99%

“…A recent study suggests that limiting therapies in the slow VT zone to anti-tachycardia pacing (ATP) only will be safe in secondary prevention with slow VT (6). Symptoms will be decisive in such a situation, but if the slow VT is welltolerated, it is postulated that the patient could benefit from avoiding shock therapies (6). However, there are no current guidelines for managing sustained slow VT requiring electrical cardioversion for termination in patients with ICDs for secondary prevention.…”

Section: Discussionmentioning

confidence: 99%

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Endo-Epicardial ablation of incessant slow monomorphic ventricular tachycardia originating from the left ventricular summit in a patient with cardiac resynchronization therapy defibrillator

Elizalde-Uribe,

Andrade-Cuellar,

Robledo-Nolasco

et al. 2023

Preprint

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Slow ventricular tachycardia (VT) in patients with ICDs is uncommon, and its impact is considered minor. However, understanding its long-term risk is crucial since high-risk patients might benefit from prophylactic ablation and device programming to reduce inappropriate ICD therapies. We present the case of a 69-year-old man with a history of acute myocardial infarction and aborted sudden cardiac death in 2002 underwent angioplasty with stent placement in the anterior descending artery and implantation of a CRT-D. He remained in NYHA functional class I. In 2019, he experienced two appropriate shocks for ventricular tachycardia (VT), and in 2021, three sustained VT events within 24 hours. A catheter ablation was decided to treat the VT, with a successful endo-epicardial approach. After 48 hours without VT recurrence, he was discharged. In the presented case of ischemic cardiomyopathy, an endo-epicardial approach was crucial for successful ablation of VT originating from the left ventricular summit. This case emphasizes the need for individualized ablation strategies in patients with incessant slow VT and ICDs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%