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Europace Advance Access published online on June 13, 2006
Europace, doi:10.1093/europace/eul049
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© The European Society of Cardiology 2006. All rights reserved
Received July 27, 2005
Accepted March 12, 2006

Article

Electrical storm of monomorphic ventricular tachycardia after a cardiac-resynchronization-therapy-defibrillator upgrade

Bharat K. Kantharia 1 *, Jigar A. Patel 1, Bipinpreet S. Nagra 1, and Gary S. Ledley 1

1 Division of Cardiology, Albert Einstein Medical Center, 5501 Old York Road, Levy 3 East, Philadelphia, PA, USA

* To whom correspondence should be addressed.
Bharat K. Kantharia, E-mail: bkantharia{at}yahoo.com


  Abstract

In patients with significant left ventricular dysfunction and congestive heart failure despite optimal medical therapy, implantation of cardiac resynchronization therapy-defibrillation (CRT-D) devices has been shown to improve symptoms and mortality. In this report, we describe a case of a patient with ischaemic cardiomyopathy who developed incessant ventricular tachycardia (VT) after undergoing an upgrade from an implantable cardioverter defibrillator to a CRT-D device. The patient required multiple anti-arrhythmic agents, removal of the coronary sinus lead, and radiofrequency ablation to control VT. Thus, in rare patients, the CRT devices may potentially cause ‘proarrhythmia’ with serious consequences.

Keywords: Cardiac resynchronization therapy; Ventricular tachycardia; Cardiomyopathy; Congestive heart failure; Anti-arrhythmic agents; Radiofrequency ablation; Proarrhythmia.
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