Case report: Masked premature ventricular contractions and Intradevice interaction causing ventricular Arrythmias

IF 1.2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of electrocardiology Pub Date : 2025-06-15 DOI:10.1016/j.jelectrocard.2025.154051

Aravinthan Vignarajah MD , Jose Aguilera MD , Justin Z. Lee MD

引用次数: 0

Abstract

An implantable cardioverter-defibrillator (ICD) intended to prevent malignant arrhythmias can, in rare cases, precipitate them. We report a 44-year-old man with cardiac sarcoidosis who suffered recurrent polymorphic ventricular tachycardia (VT) and ventricular fibrillation (VF) due to an intradevice timing interaction. Premature ventricular contractions (PVCs) fell within the ICD's post–atrial pacing ventricular blanking period and went undetected (“masked”), resulting in ventricular pacing during the vulnerable period (R-on-T), which triggered VT/VF. Reprogramming the device from DDD to VVI mode prevented further arrhythmias. This case highlights the importance of individualized ICD programming to avoid device-induced arrhythmias.

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病例报告：隐蔽性室性早搏和装置内相互作用引起室性心律失常

用于预防恶性心律失常的植入式心律转复除颤器（ICD）在极少数情况下会导致恶性心律失常。我们报告一名44岁男性心脏结节病患者，由于装置内定时相互作用，复发性多态性室性心动过速（VT）和心室颤动（VF）。室性早搏（室性早搏）发生在ICD后心房起搏心室空白期，未被发现（“掩盖”），导致易损期室性起搏（R-on-T），触发VT/VF。将设备从DDD模式重新编程为VVI模式可以防止进一步的心律失常。本病例强调了个性化ICD编程的重要性，以避免设备引起的心律失常。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of electrocardiology 医学-心血管系统

CiteScore

2.70

自引率

7.70%

发文量

152

审稿时长

38 days

期刊介绍： The Journal of Electrocardiology is devoted exclusively to clinical and experimental studies of the electrical activities of the heart. It seeks to contribute significantly to the accuracy of diagnosis and prognosis and the effective treatment, prevention, or delay of heart disease. Editorial contents include electrocardiography, vectorcardiography, arrhythmias, membrane action potential, cardiac pacing, monitoring defibrillation, instrumentation, drug effects, and computer applications.