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A 50-year-old male underwent a mechanical tricuspid and mitral valve replacement after ventricular septum rupture because of an inferior wall infarction, followed by implantation of a dual chamber pacemaker (Medtronic Adapta ADDRL1; Medtronic Inc, Minneapolis, MN) for complete heart block. Because of the mechanical tricuspid valve ventricular pacing was accomplished by a Medtronic 4194 lead placed in a posterior branch of the coronary sinus (CS). An implantable cardioverter defibrillator (ICD) implantation was scheduled because of an ejection fraction of 29% after a previous myocardial infarction, The New York Heart Association class III, and development of nonsustained ventricular arrhythmias. Owing to the presence of the mechanical tricuspid valve, we preferred to implant a subcutaneous …

circulation. arrhythmia and electrophysiology

Inappropriate Shock Because of Triple Counting in a Patient With a Subcutaneous Implantable Cardioverter Defibrillator Corrected by Initiation of Dual Site Left Ventricular Pacing