Saturday, February 24, 2018

AICD Failure to Fire During Episode of Sustained Ventricular Tachycardia

A 65 year old with an AICD.  He had a sustained run of VT.  The AICD failed to respond to the episode of VT.  It was interrogated and it was found that the AICD did not respond and attempt overdrive pacing because the rate was set too high.  The patient became unresponsive and was externally defibrillated at 200 J. 

The strips off the monitor show what appears to be P waves, the pacemaker interogator thought that they might be retrograde P waves.  I asked if she thought that perhaps the AICD perhaps interpreted this as a sinus rhythm with a wide QRS, but she did not think so. The second strip show that the heart and pacemaker did respond to the defibrillaton.

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