Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.17/2040
Título: The Proarrhythmic Effect of Cardiac Resynchronization Therapy: an Issue that Should Be Borne in Mind
Outros títulos: Terapêutica de Ressincronização Cardíaca e Efeito Pró-Arrítmico: um Problema que Deve Ser Lembrado
Autor: Cabanelas, N
Oliveira, MM
Nogueira da Silva, M
Silva Cunha, P
Valente, B
Lousinha, A
Santos, S
Branco, LM
Cruz Ferreira, R
Palavras-chave: HSM CAR
Cardiac Resynchronization Therapy/adverse effects
Tachycardia, Ventricular/etiology
Data: 2014
Editora: Sociedade Portuguesa de Cardiologia
Citação: Rev Port Cardiol. 2014 May;33(5):309.e1-7
Resumo: The demonstrated benefits of cardiac resynchronization therapy (CRT) in reducing mortality and hospitalizations for heart failure, improving NYHA functional class and inducing reverse remodeling have led to its increasing use in clinical practice. However, its potential contribution to complex ventricular arrhythmias is controversial.We present the case of a female patient with valvular heart failure and severe systolic dysfunction, in NYHA class III and under optimal medical therapy, without previous documented ventricular arrhythmias. After implantation of a CRT defibrillator, she suffered an arrhythmic storm with multiple episodes of monomorphic ventricular tachycardia (VT), requiring 12 shocks. Subsequently, a pattern of ventricular bigeminy was observed, as well as reproducible VT runs induced by biventricular pacing. Since no other vein of the coronary sinus system was accessible, it was decided to implant an epicardial lead to stimulate the left ventricle, positioned in the left ventricular mid-lateral wall. No arrhythmias were detected in the following six months. This case highlights the possible proarrhythmic effect of biventricular pacing with a left ventricular lead positioned in the coronary sinus venous system.
Peer review: yes
URI: http://hdl.handle.net/10400.17/2040
Aparece nas colecções:CAR - Artigos

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