A 59-year-old man suffering from severe dilated cardiomyopathy with a LVEF <30%, recipient of an EnTrust VR single chamber ICD for primary prevention, is seen for pre-syncope and palpitations. (Same as in tracing 22.)
In this patient, ATP during charge of the capacitors had terminated several episodes of tachyarrhythmias. This ICD model incorporates a “charge saver” algorithm that forces the delivery of ATP before the charge, provided that ATP delivered during the charge had previously terminated 2 episodes of tachycardia. This algorithm meets 2 important goals : 1) The delivery of fewer shocks, and 2) a lesser drain of the battery. Its potential limitation is that failure of ATP delays the charge of the capacitors for a few seconds. While ATP before capacitor charge can be programmed upfront, it seems wiser to activate it after the observation of several successful ATP delivered during the charge.
Tachycardia detected in the VF zone, terminated by a burst of ATP before the charge of the capacitors.
