Implanted defibrillators in trouble: initial device misclassification leads to correct diagnosis-a case series.

Abstract

AIMS:

Supraventricular tachycardia, mistakenly diagnosed as ventricular tachycardia, may lead to inappropriate ICD therapy. Inappropriate ICD therapy associates with increased morbidity and mortality. A reduction of inappropriate therapy is therefore desired.

METHODS AND RESULTS:

We present three different cases that beautifully illustrate the diagnostic possibilities of stored electrograms. Initial differential diagnoses in all three patients included ventricular tachycardia, focal atrial tachycardia, atrio-ventricular re-entry tachycardia, and atrio-ventricular nodal re-entry tachycardia. The first case was diagnosed as atrio-ventricular nodal re-entry tachycardia. In the second case, atrio-ventricular re-entry tachycardia was revealed. Ectopic atrial tachycardia was the reason for inappropriate therapy in the third patient.

CONCLUSION:

Thorough analysis of stored electrograms yielded correct diagnosis in all cases, which subsequently was confirmed by electrophysiological study.

• Authors: Andreas Müssigbrodt, Helge Knopp, Timm Seewöster, Sebastian Hilbert, Johannes Lucas, Kerstin Nowotnick, Borislav Dinov, Gerhard Hindricks, Arash Arya, Sergio Richter
• Journal: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology (Europace) Vol. 19 Issue 5 Pg. 795-801 (May 01 2017) ISSN: 1532-2092 [Electronic] England
• PMID: 27256418 (Publication Type: Case Reports, Journal Article)
• Copyright: Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: [email protected].

Topics

• Adult
• Defibrillators, Implantable
• Diagnosis, Differential
• Diagnostic Errors (prevention & control)
• Electrocardiography (methods)
• Humans
• Male
• Middle Aged
• Tachycardia, Supraventricular (diagnosis, prevention & control)
• Tachycardia, Ventricular (diagnosis, prevention & control)