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Increase in internal defibrillation threshold during acute myocardial infarction

Masaki Ota1, Yoshiaki Kaneko, Tadashi Nakajima

  • 1Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi.

Internal Medicine (Tokyo, Japan)
|September 18, 2010
PubMed

A 67-year-old man suffered an acute anteroseptal myocardial infarction complicated by multiple episodes of ventricular fibrillation, which were not systematically defibrillated by maximum, internal 35-J shocks delivered by an implanted cardioverter defibrillator (ICD). He had suffered from acute inferior myocardial infarction 6 years earlier, complicated with sustained polymorphic ventricular tachycardia (VT). Due to inducibility of sustained VT on an electrophysiologic study, an ICD was implanted. Defibrillation testing performed after healing of anteroseptal infarction was successful with a 10-J safety margin, suggesting that acute myocardial ischemia transiently elevated the internal defibrillation threshold.

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