Electrical Storm Induced by Cardiac Resynchronization: Efficacy of the Multipoint Pacing Stimulation

Abstract

Although cardiac resynchronization therapy (CRT) reduces morbidity and mortality and reverses left ventricular (LV) remodeling in heart failure patients with LV electrical dyssynchrony, induced proarrhythmia has been reported. The mechanism of CRT-induced proarrhythmia remains under debate. In this case report, a description of how a LV pacing induced polymorphic ventricular tachycardia immediately after the initiation of CRT has been reported. Changing the pacing configuration using a multipoint pacing stimulation, we can assume that VTs induced are related to the reentry mechanism facilitated by the unidirectional block. As a result, MPP pacing configuration near the scar area avoid the onset of a unidirectional block with the establishment of the reentry phenomenon thus avoiding induced VTs.