First beat antitachycardia pacing termination of monomorphic ventricular tachycardia by an extravascular defibrillator.
Patricia Azañón Cantero, Rosa Macías Ruiz, Javier Olarte et al.
✦ AI-curated · Sources linked
Case in brief
A patient with an extravascular implantable cardioverter-defibrillator (ICD) developed sustained monomorphic ventricular tachycardia (VT). The device delivered antitachycardia pacing (ATP), and the first pacing stimulus terminated the arrhythmia. Surface ECG documented the termination beat, providing a record of successful ATP delivery by an entirely extravenous system.
What made this case unusual
The surface ECG captured termination of sustained monomorphic VT by the first ATP stimulus from an extravascular ICD. The termination beat also offered insight into the interaction between the paced impulse and the VT circuit.
Diagnostic / clinical pearl
Surface ECG documentation of the termination beat can help characterize how an ATP stimulus interacts with a VT circuit, beyond confirming that pacing terminated the arrhythmia.