176-81: Implanted defibrillators in trouble: initial device misclassification leads to correct diagnosis. (10th June 2016)

• Record Type: Journal Article
• Authors: Helge, Knopp; Ebert, Micaela; Seewöster, Tim; Hilbert, Sebastian; Lucas, Johannes; Döring, Michael; Richter, Sergio; Hindricks, Gerhard; Arya, Arash; Müssigbrodt, Andreas
• Is Part Of: Europace. Volume 18(2016)Supplement 1
• Page Start: i137
• Page End: i137
• Publication Date: 2016-06-10
• Subjects: Arrhythmia -- Treatment -- Periodicals; Cardiac pacing -- Periodicals; Catheter ablation -- Periodicals; Heart -- Physiology -- Periodicals; Electrophysiology -- Periodicals; 617.4120645
• DOI: 10.1093/europace/18.suppl_1.i137c
• Languages: English
• ISSNs: 1099-5129

Abstract

Abstract: Aims: Supraventricular tachycardia, mistakenly diagnosed as VT may lead to inappropriate ICD therapy. Inappropriate ICD therapy associates with increased morbidity and mortality. A reduction of inappropriate therapy is therefore desired. Methods: We present three different cases oft SVT with consecutive atrio-ventricular activiation that beautifully illustrate the diagnostic possibilities of stored electrograms. Results: Initial differential diagnoses in all three patients included ventricular tachycardia, focal atrial tachycardia, atrio-ventricular reentry tachycardia and atrio-ventricular nodal reentry tachycardia. The first case was diagnosed as atrio-ventricular nodal reentry tachycardia. In the second case orthodromic atrio-ventricular reentry tachycardia by a conceald left accessory pathway was revealed. Ectopic atrial tachycardia was the reason for inappropriate therapy in the third patient. Conclusion: Thorough analysis of stored electrograms yielded correct diagnosis in all cases, which subsequently was confirmed by electrophysiological study.