Open AccessElectrical storm after cardiac resynchronization therapy in a patient with nonischemic cardiomyopathy: Signal‐averaged vector‐projected 187‐channel electrocardiogram‐based risk stratification for lethal arrhythmia
Author(s) -
Nakai Toshiko,
Mano Hiroaki,
Ikeya Yukitoshi,
Sonoda Kazumasa,
Ashino Sonoko,
Okumura Yasuo,
Ohkubo Kimie,
Kunimoto Satoshi,
Kasamaki Yuji,
Watanabe Ichiro,
Hirayama Atsushi,
Nakai Kenji
Publication year - 2013
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1016/j.joa.2013.05.004
Subject(s) - medicine , cardiology , amiodarone , cardiac resynchronization therapy , ventricular tachycardia , repolarization , risk stratification , atrial flutter , signal averaged electrocardiogram , discontinuation , electrocardiography , heart failure , atrial fibrillation , ejection fraction , electrophysiology
Abstract We describe treatment of atrial flutter and electrical storm presenting as incessant ventricular tachycardia (VT) after implantation of a cardiac resynchronization therapy defibrillator (CRT‐D) in a patient with dilated cardiomyopathy. No prior arrhythmic event had occurred. Our treatment strategy, including amiodarone administration, was guided in part by signal‐averaged vector‐projected 187‐channel electrocardiogram (SAVP‐ECG)‐based risk stratification for ventricular arrhythmia. Corrected recovery time (RTc) dispersion and Tpeak‐end dispersion were used to evaluate transmural dispersion of repolarization. RTc and Tpeak‐end dispersion increased during the period of electrical storm. Values were improved 2 years after CRT‐D implantation, and the amiodarone was discontinued. The VT has not recurred despite discontinuation of the antiarrhythmic agent. SAVP‐ECG‐based risk stratification for ventricular arrhythmia proved useful for the management of antiarrhythmic therapy.