Polymorphic ventricular tachycardia due to change in pacemaker programming

Elsokkari, Ihab; AbdelWahab, Amir; Parkash, Ratika

doi:10.1016/j.hrcr.2017.02.003

Cited by 5 publications

(2 citation statements)

References 18 publications

(12 reference statements)

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“…It is hypothesized to be due to triggered activity secondary to catecholamine excess affecting intracellular calcium, resulting in delayed after depolarization [ 13 ]. PM-induced polymorphic VT is an alternate scenario, it is usually in the context of the pacing algorithm being set at a lower rate, causing QT prolongation resulting in polymorphic VT [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Takotsubo cardiomyopathy following pacemaker insertion complicated with polymorphic ventricular tachycardia: a case report

Dev,

El-Din,

Vijayakumar

et al. 2024

J Med Case Reports

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Background Takotsubo cardiomyopathy is a novel form of rapidly reversible heart failure occurring secondary to a stressor that mimics an acute coronary event. The underlying etiology of the stressor is highly variable and can include medical procedures. Pacemaker insertion is an infrequent cause of Takotsubo cardiomyopathy. Case presentation An 86-year-old Caucasian woman underwent an uncomplicated pacemaker insertion for symptomatic complete heart block in the background of slow atrial fibrillation. A transient episode of polymorphic ventricular tachycardia was noted on day 1 following the procedure; however, her pacemaker was checked and, as she remained stable, she was discharged home. She presented again 5 days later with symptomatic heart failure. Chest X-ray confirmed pulmonary edema. Echocardiography confirmed new onset severe left ventricle dysfunction. Pacemaker checks were normal and lead placement was confirmed. Though her troponin I was elevated, her coronary angiogram was normal. Contrast enhanced echocardiography suggested apical ballooning favoring Takotsubo cardiomyopathy. She was treated for heart failure and made a good recovery. Her follow-up echocardiography a month later showed significant improvement in left ventricle function. Conclusions Takotsubo cardiomyopathy is mediated by a neuro-cardiogenic mechanism due to hypothalamic–pituitary–adrenal axis activation. It generally has a good prognosis. Complications though uncommon, can occur and include arrhythmias. Pacemaker insertion as a precipitant stressor is an infrequent cause of Takotsubo cardiomyopathy. As pacemaker insertions are more frequent in the elderly age group, this phenomenon should be recognized as a potential complication.

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Section: Discussionmentioning

confidence: 99%

Takotsubo cardiomyopathy following pacemaker insertion complicated with polymorphic ventricular tachycardia: a case report

Dev,

El-Din,

Vijayakumar

et al. 2024

J Med Case Reports

View full text Add to dashboard Cite

show abstract

“…Elsokkari and colleagues 15 reported a case of PMVT in a patient with complete heart block switched from VDD 50-120 bpm to VVI 50 bpm transvenous pacing. They noted that this change in pacing mode was the functional equivalent of the patient having had de novo AV junction ablation.…”

Section: Discussionmentioning

confidence: 99%