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Europace Advance Access published online on November 10, 2009
Europace, doi:10.1093/europace/eup356
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

SHORT COMMUNICATION

Rate smoothing induced ventricular arrhythmia and syncope: a new device-induced proarrhythmia

Siva K. Mulpuru1,2,*, Hiroshi Fujita3 and Cesare Saponieri4

1 Cardiovascular Diseases, Beth Israel Medical Center, 1st Avenue at 16th Street, New York, NY 10003, USA; 2 Long Island College Hospital, Brooklyn, NY, USA; 3 Department of Internal Medicine, Long Island College Hospital, Brooklyn, NY, USA; 4 Cardiac Electrophysiology, Division of Cardiology, Long Island College Hospital, Brooklyn, NY, USA

A 74-year-old male presented to our emergency room with history of sudden onset palpitations associated with syncope. He had a single-chamber implantable cardioverter defibrillator implanted for secondary prevention of sudden cardiac death due to ischaemic cardiomyopathy. Interrogation of the device revealed episodes of non-sustained ventricular tachycardia (NSVT) at 220 ms. Post-tachycardia, another episode of NSVT with longer duration, was induced by rate smoothing pacing algorithm following premature ventricular beats. We describe this unique form of device-related proarrhythmia causing syncope.

* Corresponding author. Tel: +1 718 928 5013, Fax: +1 718 780 4872, Email: osmecan2000{at}yahoo.com

Manuscript submitted 23 July 2009. Accepted after revision 15 October 2009.


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