Ventricular arrhythmias are an important cause of cardiovascular morbidity and mortality, particularly in those with structural heart disease, inherited cardiomyopathies, and channelopathies. The goals of ventricular arrhythmia management include symptom relief, improving quality of life, reducing implantable cardioverter defibrillator shocks, preventing deterioration of left ventricular functi...

BACKGROUND In Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy (MADIT-CRT), patients with non-left bundle branch block (LBBB; including right bundle branch block, intraventricular conduction delay) did not have clinical benefit from cardiac resynchronization therapy with defibrillator (CRT-D). We hypothesized that baseline PR interval modulates clinical r...

The second ECG recorded supraventricular tachycardia at the time his hemodynamic status deteriorated and decision was made to perform electrical cardioversion with 120 Joules of biphasic synchronized direct current with follow up ECG that showed atrial paced rhythm (Figure 1B). His condition improved and started on amiodarone 200 mg, anticoagulation, and subsequent follow up for ICD reprogrammi...

Results A total of 1,544 ICD patients (79% male, age 61 13 years) were included in the analysis. During the follow-up period of 41 18 months, 13% experienced 1 inappropriate shocks. The cumulative incidence steadily increased to 18% at 5-year follow-up. Independent predictors of the occurrence of inappropriate shocks included a history of atrial fibrillation (hazard ratio [HR]: 2.0, p 0.01) and...

BACKGROUND The primary method for monitoring implantable cardioverter-defibrillator lead integrity is periodic measurement of impedance. Sprint Fidelis leads are prone to pace-sense lead fractures, which commonly present as inappropriate shocks caused by oversensing. METHODS AND RESULTS We developed and tested an algorithm to enhance early identification of lead fractures and to reduce inappr...

The entirely subcutaneous implantable cardioverter defibrillator (S-ICD(®)) is emerging as a widely accepted therapeutic alternative to a conventional implantable cardioverter defibrillator (ICD) for prevention of sudden cardiac death. Essentially, the S-ICD(®) is promising in terms of reduction of electrode-related complications such as lead failure and infections. The conventional transvenous...

Unfortunately, the authors have missed our 2 publications on this topic which have been tested in a larger population of CD patients with an implantable cardioverter-defibrillator (ICD) (FECHA study) [2,3]. We included 98 patients from 14 centers in Latin America, all of them with CD cardiomyopathy and an implantable cardioverter-defibrillator (ICD). The mean follow-up was 33±20 months. Mean LV...

BACKGROUND Sustained ventricular tachycardia (VT) can be unstable, can be associated with serious symptoms, or can be stable and relatively free of symptoms. Patients with unstable VT are at high risk for sudden death and are best treated with an implantable defibrillator. The prognosis of patients with stable VT is controversial, and it is unknown whether implantable cardioverter-defibrillator...

Twiddler’s syndrome is a rare condition caused by coiling of the leads, leading to malfunction in pacemaker or automated implantable cardioverter-defibrillator (AICD). It was first described Bayliss 1968 as rare, but potentially fatal complication treatment1. Inappropriate shocks due malfunctioning AICD can be devastating, traumatic, patient.

The implantable cardioverter-defibrillator (ICD) is effective to prevent sudden cardiac death (SCD) in selected patients with heart disease known to be at high risk for ventricular arrhythmia. Nevertheless, this invasive and definitive therapy is not indicated in patients with potentially transient or reversible causes of sudden death, or in patients with temporary contra-indication for ICD pla...