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New-onset ventricular tachycardia after cardiac resynchronization therapy
Andrea Di Cori1, Maria Grazia Bongiorni, Giuseppe Arena
1Cardiac and Thoracic Department, University of Pisa, Italy. a.dicori@virgilio.it
Summary
Biventricular pacing (BivP) for heart failure may trigger ventricular tachycardia (VT) in some patients. Discontinuing BivP resolved VT episodes, suggesting a potential link between cardiac resynchronization therapy and arrhythmias.
Area of Science:
- Cardiology
- Electrophysiology
- Heart Failure Management
Background:
- Coronary artery disease with healed myocardial infarction is a common cause of ventricular tachycardia (VT).
- Biventricular pacing (BivP), a form of cardiac resynchronization therapy (CRT), is established for treating severe heart failure.
- The precise relationship between CRT/BivP and ventricular arrhythmias remains incompletely understood.
Observation:
- A patient without prior arrhythmic history experienced multiple VT episodes immediately following CRT initiation.
- These VT episodes ceased upon discontinuation of BivP.
Findings:
- Cardiac resynchronization therapy (CRT) may precipitate ventricular tachycardia (VT) in susceptible individuals.
- Biventricular pacing (BivP) discontinuation led to the resolution of VT in this case.
- This suggests a potential pro-arrhythmic effect of CRT/BivP in specific patient contexts.
Implications:
- Clinicians should consider the potential for CRT/BivP to induce VT in patients with underlying heart disease.
- Further research is warranted to elucidate the mechanisms linking CRT/BivP and ventricular arrhythmias.
- Careful patient selection and monitoring may be necessary for those undergoing CRT/BivP to mitigate arrhythmia risk.