A 68-year-old recipient of an EnTrust VR single chamber ICD implanted for secondary prevention after a large anterior myocardial infarction, syncope and VT, presents with recurrent syncope and perception of ICD shock.
To treat VT at rates >200 bpm entering the FVT or VF zone, a ramp or a burst can be programmed to be delivered during charge of the capacitors. We recommend programming a burst, as a recent study found burst more effective and less likely to accelerate VT than ramp. This example illustrates the proarrhythmic effects of a ramp in the FVT zone.
The VT accelerated to a rapid and organized rhythm entering the VF zone. This episode was terminated by a burst of ATP delivered during charge of the capacitors.
