(FIT)-Module 5 Workshop 9: Arrhythmia Case Studies (Putting It All Together for the Boards)-Ellenbogen Case 3 Question

Video Transcription

Video Summary

A 66-year-old male with a history of ischemic cardiomyopathy, AFib, diabetes, and class 1 heart failure experienced a shock from his first-generation subcutaneous ICD while working. He has an ejection fraction of 20% and had an LV thrombus at the time of device implantation, preventing DFT testing. During device interrogation, it was noted the patient had one treated episode resulting in one shock. The possible reasons for the shock include myopotential over-sensing, air entrapment in the header, T-wave over-sensing, ventricular tachycardia, or supraventricular tachycardia. The task is to study the tracing to determine the cause.

Keywords

ischemic cardiomyopathy

subcutaneous ICD

myopotential over-sensing

ventricular tachycardia

T-wave over-sensing