Avoid common mistakes on your manuscript.
A 31-year-old patient with Brugada syndrome presented at our clinic after an electrical shock from his dual-chamber implantable cardioverter-defibrillator (ICD – Biotronik Iperia), implanted in secondary prevention of sudden cardiac death (ventricular fibrillation zone > 214 bpm, detection counter 18/24; monitor ventricular tachycardia zone > 176 bpm with supraventricular tachycardia discriminators). A regular tachycardia was stored with a total absence of atrial electrograms (defective atrial lead), but a supraventricular origin was suspected (similar QRS morphology on ventricular electrograms compared with sinus rhythm). As the electrophysiological study could not induce any arrhythmia nor evoke dual atrioventricular nodal physiology, the atrial lead was replaced in consideration of potential future events. Two months later, he received another ICD shock, again after exercise-induced palpitations with neck fullness.
Fig. 1 shows the new episode as stored in the device memory. What would be your diagnosis and your next step or treatment?
Answer
You will find the answer elsewhere in this issue.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
About this article
Cite this article
Ströker, E., de Asmundis, C., Chierchia, G.B. et al. Only a boost away from re-entry. Neth Heart J 25, 594–595 (2017). https://doi.org/10.1007/s12471-017-0990-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12471-017-0990-3