Roy M. John, MD, PhD
Address for correspondence:
Roy M. John, MD, PhD, Section of Cardiology, Lahey Clinic
Medical Center, 41 Mall Road, Burlington, MA 01805. Email:
roy.m.john@lahey.org
A
70 year old male underwent placement of a Medtronic Marquis DR ICD following
syncope. He has coronary artery disease and severe LV dysfunction and was
inducible for rapid hemodynamically unstable ventricular tachycardia at
intracardiac electrophysiological study prior to implantation of the ICD.
Three weeks later, he presents with an ICD shock. He had been drinking excessive
amounts of alcohol and experienced lightheadedness prior to experiencing
the ICD shock. Electrogram of the episode obtained upon device interrogation
is shown in
Figure 1:
Figure 1: From top to bottom, the traces represent atrial electrograms,
ventricular electrograms, atrial and ventricular marker channels with inter-beat
intervals.
Which of the following is a true statement regarding this arrhythmia?
1. A ventricular arrhythmia is appropriately converted by
the ICD shock
2. Activation of SVT discrimination algorithms would have prevented an
ICD shock
3. A ventricular arrhythmia leads to the development of atrial fibrillation
4. There is 1:1 atrio-ventricular conduction during an atrial tachycardia
leading to an ICD shock
5. An AV node dependent supra-ventricular tachycardia is appropriately
terminated by the ICD shock
Arrhythmia Quiz 4
- Answer
