Tachycardias with a 2:1 ventricular-to-atrial relationship require integrating surface ECG, device tracings, and electrophysiological findings to prevent misclassification by ICD algorithms.
This case highlights the importance of integrating surface ECG, device tracings, and electrophysiological findings to correctly diagnose and treat complex tachycardias, avoiding misclassification by device algorithms.
Tasa de eventos absoluta: 0% vs 0%
We report a 52-year-old man with coronary artery disease, reduced left ventricular ejection fraction, and a cardiac resynchronization therapy–defibrillator (CRT-D), admitted to the emergency department for palpitations. Surface ECG showed a wide-complex tachycardia with a 2:1 ventricular-to-atrial (V:A) relationship. Device interrogation revealed episodes detected in the ventricular tachycardia monitor zone, according to the atrioventricular discrimination algorithms. Detailed analysis of surface ECG and device intracardiac electrograms was performed, followed by an electrophysiological study and catheter ablation of the responsible circuit of the tachycardia. This case illustrates the diagnostic complexity and differential diagnosis of tachycardias presenting with a 2:1 V:A relationship and highlights the importance of integrating surface ECG, device tracings, and electrophysiological findings to correctly identify the underlying mechanism, to avoid misclassification by device algorithms, and to treat the arrhythmia effectively.
Micari et al. (Sun,) reported a other. Tachycardias with a 2:1 ventricular-to-atrial relationship require integrating surface ECG, device tracings, and electrophysiological findings to prevent misclassification by ICD algorithms.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: