A permanently implanted endocardial electrode complicating ventricular tachycardia with a second VT

Area of Science:

• Cardiology
• Electrophysiology
• Medical Device Technology

Background:

• Recurrent ventricular tachycardia (VT) poses a significant clinical challenge.
• Pacemaker implantation, specifically VVI pacing, is sometimes used to manage refractory VT.

Observation:

• A VVI pacemaker was implanted to suppress recurrent VT.
• The implanted endocardial electrode unexpectedly triggered a secondary, more severe VT.

Findings:

• The VVI pacemaker failed to suppress the intended VT.
• The permanent endocardial electrode acted as an etiologic factor for a new, more rapid, and severe VT.

Implications:

• Permanent endocardial electrodes should be considered potential causes of new-onset VT in patients with pacemakers.
• This finding necessitates careful evaluation of pacing hardware in cases of pacemaker-associated VT.