68 year old man implanted with a dual chamber ICD InSync Sentry in the context of a severe ischemic cardiomyopathy.
This episode corresponds to an episode of atrial flutter with a 2:1 conduction to the ventricle. It was successfully recognized by the ICD.
This observation involves 1) thinking about anticoagulation, 2) discussing the opportunity to treat the patient with an antiarrhythmic drug or with an ablation procedure.
For this patient, the PR Logic algorithm led to the diagnosis of AF/A flutter :
1) No R-wave far field was detected;
2) The P to R-wave relationship corresponded to an atrial flutter pattern;
3) The AF counter was fulfilled
Three detection zones are programmed; discrimination in the VT zone is based on the PR Logic algorithm and the stability criterion; the present episode of tachycardia is stable but the PR logic algorithm concludes to an episode of SVT (AF or A Flutter); the ICD is in automatic mode commutation secondary to this arrhythmia.
