Persistent Slow Ventricular Tachycardia following AICD-A Shocking Dilemma!

Akshyaya Pradhan, Dhananjay Kumar, Pravesh Vishwakarma, Rishi Sethi, Varun S Narain
2019 Journal of Clinical and Diagnostic Research  
A 74-year-old male presented to the emergency department with complaints of palpitation for past two days. He had no associated complaints of chest pain, dyspnea, presyncope or syncope. He was a known case of ischaemic cardiomyopathy and a dual chamber Implantable Cardioverter Defibrillator (ICD) was implanted ten years back for secondary prevention of sudden cardiac death. He was a non smoker, non-alcoholic, non-diabetic with longstanding hypertension. Patient was asymptomatic during regular
more » ... tpatient cardiology follow-up. His concurrent oral medications included carvedilol 12.5 mg twice daily, amiodarone 100 mg once daily, ramipril 5 mg and torsemide 20 mg both once daily and was compliant to these guidelines based therapies. On examination, there was no evidence of haemodynamic instability with a blood pressure of 110/64 mmHg, heart rate of 140 beats/ minute and a respiratory rate 16/minute. His cardiovascular system examination was within normal limits. Two-dimensional transthoracic echocardiography was done which suggested global left ventricular hypokinesia with a Left Ventricular Ejection Fraction (LVEF) of 34% (calculated by average of M-Mode and bi plane Simpson's method) and mild mitral regurgitation.
doi:10.7860/jcdr/2019/38477.12531 fatcat:p3nypzlhq5aofp4s2qn2vlzifa