Arrhythmic Storm Due to ICD Atrial Lead Malfunction
Davide Fabbricatore1,2, Ward Heggermont1, Dimitri Buytaert1
1Cardiovascular Research Centre OLV, Aalst, Belgium.
JACC. Case Reports
|June 13, 2022
Summary
A fractured atrial lead in a young woman with long-QT syndrome caused an "arrhythmic storm." This case underscores the critical importance of selecting the right implantable cardioverter-defibrillator and pacing mode for patient safety.
Area of Science:
- Cardiology
- Medical Device Technology
Background:
- Long-QT syndrome (LQTS) is a serious cardiac condition requiring advanced management.
- Dual-chamber implantable cardioverter-defibrillators (ICDs) are used to manage life-threatening arrhythmias in LQTS patients.
Observation:
- A young woman with LQTS experienced an
Findings:
- Atrial lead fracture in a dual-chamber ICD system can precipitate severe arrhythmias, termed "arrhythmic storm."
- The specific type of ICD and pacing modality significantly influence patient outcomes and device reliability.
Implications:
- This case emphasizes the need for careful consideration of device lead integrity and pacing strategies in LQTS management.
- Optimal device selection and implantation techniques are crucial for preventing catastrophic device-related complications.
Keywords:
AAI, atrial-pacing atrial-sensing inhibited-responseDDD, dual-pacing dual-sensing dual-responseEGM, electrogramICD, implantable cardioverter-defibrillatorLQTS, long QT syndromeVP, ventricular paced (beat)VVI, ventricular-pacing ventricular-sensing inhibited-responsecardiac pacemakergenetic disordersventricular tachycardia
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