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Holter Documented Sudden Death in a Patient with an Implanted Defibrillator
Author(s) -
BIRGERSDOTTERGREEN ULRIKA,
ROSENQVIST MÅRTEN,
LINDEMANS FRED W.,
RYDÉN LARS,
RADEGRAN KJELL
Publication year - 1992
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1992.tb03094.x
Subject(s) - medicine , cardioversion , defibrillation , cardiology , ventricular tachycardia , ventricular fibrillation , supraventricular tachycardia , atrial fibrillation , implantable cardioverter defibrillator , supraventricular arrhythmia , tachycardia
A 68‐year‐old man with recurrent attacks of monomorphic ventricular tachycardia (VT) received a pacer cardioverter defifarillalor featuring antitachycardia pacing and cardioversion/defibrillation. Over 300 episodes of VT were successfully terminated by antitachycardia pacing. During Holter monitoring the patient experienced supra ventricular tachycardia with delivery of multiple antitachycardia pacing, cardioversion, and defibrillation therapies ending with the death of the patient. The following factors played a role in the unfortunate outcome of this patient: 1. triggering of VT therapy by an unexpected high sinus rate; 2. atrial fibrillation induced by cardioversion therapy; 3, a gradual and continuous increase in rate during atrial fibrillation possibly caused by repeated VT and ventricular fibrillation therapies and/or by a thrombus, found at autopsy, in a bypass graft; and 4. the limited ability of presently available defibrillators to distinguish between ventricular and supraventricular arrhythmias.