(FIT)-Module 5 Workshop 8: Device Cases-Poole Workshop 8

Poole Workshop 8

Pdf Summary

In these workshop cases, various device-related questions are discussed. The first case involves a patient with a dual chamber pacemaker who experiences episodes of atrial tachycardia/atrial fibrillation. The best answer for the observed event is determined to be physiologic oversensing. Next, a patient with an ICD is presented with a 1:1 tachycardia. The most likely rhythm diagnosis is determined to be AV node reentrant tachycardia. Another case involves a patient with a new transvenous ICD who presents with atrial undersensing and noise on device recordings. The most likely explanation for the findings is determined to be a ventricular pace/sense lead fracture. In a patient with an ICD shock, the rhythm is identified as atrial fibrillation and the shock is determined to be appropriate for ventricular tachycardia. A patient with a CRT-D is presented with a tachycardia and the most likely diagnosis is determined to be AV nodal reentry tachycardia. In the case of a patient with a dual chamber transvenous ICD, the EGMs show evidence of a ventricular lead fracture. Lastly, a patient who had an out-of-hospital cardiac arrest is discussed. The patient does not have STEMI but has abnormal cardiac function and is considered a candidate for an ICD based on contemporary guidelines.

Keywords

dual chamber pacemaker

atrial tachycardia

atrial fibrillation

physiologic oversensing

implantable cardioverter defibrillator (ICD)

AV node reentrant tachycardia

ventricular lead fracture

cardiac resynchronization therapy defibrillator (CRT-D)

ventricular tachycardia

out-of-hospital cardiac arrest