open access

Vol 14, No 2 (2019)
Electrotherapy
Published online: 2019-05-22
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Ineffective cardioverter-defibrillator therapy due to an increase in defibrillation threshold

Tomasz Pawlik, Agnieszka Wojdyła-Hordyńska, Grzegorz Hordyński
DOI: 10.5603/FC.2019.0041
·
Folia Cardiologica 2019;14(2):220-222.

open access

Vol 14, No 2 (2019)
Electrotherapy
Published online: 2019-05-22

Abstract

We present the case report of a 28 year-old man with postmyocarditis cardiomyopathy and cardioverter-defibrillator (ICD) implantation in secondary prevention. He survived an episode of circulatory arrest due to ventricular fibrillation/ polymorphic ventricular tachycardia. All high energy therapy delivered by ICD was unsuccessful. The reason for the failure of the therapy was an increase in the defibrillation threshold. The implantation of an additional subcutaneous lead lowered the defibrillation threshold.

Abstract

We present the case report of a 28 year-old man with postmyocarditis cardiomyopathy and cardioverter-defibrillator (ICD) implantation in secondary prevention. He survived an episode of circulatory arrest due to ventricular fibrillation/ polymorphic ventricular tachycardia. All high energy therapy delivered by ICD was unsuccessful. The reason for the failure of the therapy was an increase in the defibrillation threshold. The implantation of an additional subcutaneous lead lowered the defibrillation threshold.
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Keywords

high defibrillation threshold; unsuccessful ICD defibrillation; subcutaneous defibrillation lead

Supplementary Files (2)
(Fig. 3 chest X-ray with subcutaneous lead implanted)
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About this article
Title

Ineffective cardioverter-defibrillator therapy due to an increase in defibrillation threshold

Journal

Folia Cardiologica

Issue

Vol 14, No 2 (2019)

Pages

220-222

Published online

2019-05-22

DOI

10.5603/FC.2019.0041

Bibliographic record

Folia Cardiologica 2019;14(2):220-222.

Keywords

high defibrillation threshold
unsuccessful ICD defibrillation
subcutaneous defibrillation lead

Authors

Tomasz Pawlik
Agnieszka Wojdyła-Hordyńska
Grzegorz Hordyński

References (7)
  1. Bertomeu-González V, Moreno-Arribas J, Castillo-Castillo J, et al. Etiology and Programming Effects on Shock Efficacy in ICD Recipients. Pacing Clin Electrophysiol. 2016; 39(1): 73–80.
  2. Bänsch D, Bonnemeier H, Brandt J, et al. NORDIC ICD Trial Investigators. Intra-operative defibrillation testing and clinical shock efficacy in patients with implantable cardioverter-defibrillators: the NORDIC ICD randomized clinical trial. Eur Heart J. 2015; 36(37): 2500–2507.
  3. Miyake CY, Webster G, Czosek RJ, et al. Efficacy of implantable cardioverter defibrillators in young patients with catecholaminergic polymorphic ventricular tachycardia: success depends on substrate. Circ Arrhythm Electrophysiol. 2013; 6(3): 579–587.
  4. Papaioannou GI, Kluger J. Ineffective ICD therapy due to excessive alcohol and exercise. Pacing Clin Electrophysiol. 2002; 25(7): 1144–1145.
  5. Margos PN, Schomburg R, Kynast J, et al. Termination of ventricular tachycardia with antitachycardia pacing after ineffective shock therapy in an ICD recipient with hypertrophic cardiomyopathy. Indian Pacing Electrophysiol J. 2009; 9(1): 64–70.
  6. Yasuda M, Nakazato Y, Sasaki A, et al. Ventricular fibrillation refractory to ICD therapy. Intern Med. 2005; 44(8): 829–831.
  7. Erkapic D, Amberger F, Bushoven P, et al. More safety with more energy: survival of electrical storm with 40-J shocks. Herzschrittmacherther Elektrophysiol. 2011; 22(4): 252–254.

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