Polymorphic ventricular tachycardia due to change in pacemaker programming Ihab Elsokkari, MBBCh, MMed, FRACP, Amir Abdelwahab, MBBCh, MSc, MD, Ratika.

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Presentation transcript:

Polymorphic ventricular tachycardia due to change in pacemaker programming Ihab Elsokkari, MBBCh, MMed, FRACP, Amir Abdelwahab, MBBCh, MSc, MD, Ratika Parkash, MD, MS, FRCPC HeartRhythm Case Reports Volume 3, Issue 5, Pages 243-247 (May 2017) DOI: 10.1016/j.hrcr.2017.02.003 Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 1 Electrocardiogram on presentation. Sinus rhythm with complete atrioventricular (AV) dissociation and ventricular paced complexes. Ventricular rate 50 beats per minute. QTc 550 msec. JTc 383 msec. Biphasic T wave is a high-risk feature in patients with acquired AV block. HeartRhythm Case Reports 2017 3, 243-247DOI: (10.1016/j.hrcr.2017.02.003) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 2 A: Polymorphic ventricular tachycardia on pacemaker interrogation (note occasional ventricular under-sensing). B: Polymorphic ventricular tachycardia on telemetry. HeartRhythm Case Reports 2017 3, 243-247DOI: (10.1016/j.hrcr.2017.02.003) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 3 A: Electrocardiogram (ECG) prior to patient’s VDD pacemaker extraction: Patient is paced in VDD mode with a lower pacing rate of 50 beats per minute (bpm). P waves are tracked by the pacemaker, resulting in a ventricular rate of 64 bpm. QTc 454 msec, JTc 258 msec. B: ECG on presentation: Patient is paced in VVIR mode with a lower pacing rate of 50 bpm. QTc 550 msec, JTc 383 msec. C: ECG prior to discharge: Patient is paced in VVIR mode with a lower pacing rate of 80 bpm. QTc 485 msec, JTc 358 msec. HeartRhythm Case Reports 2017 3, 243-247DOI: (10.1016/j.hrcr.2017.02.003) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Supplemental Figure 1 HeartRhythm Case Reports 2017 3, 243-247DOI: (10.1016/j.hrcr.2017.02.003) Copyright © 2017 Heart Rhythm Society Terms and Conditions