This 83-year-old man received a Biotronik Lumax 740 HF-T triple chamber defibrillator in the context of very severe ischemic cardiomyopathy with LBBB. He suffered multiple episodes of VT treated with antitachycardia pacing.
This patient presented with multiple episodes of VT responsible for his hemodynamic degradation. Patients in advanced heart failure often present with this kind of VT (relatively slow with very wide QRS). To prevent double counting, the post-sensing ventricular blanking period must be lengthened, which is achievable with the Biotronik defibrillators. Since the episodes were protracted and contributed the clinical degradation of the patient, it seemed appropriate to program a slow treatment zone. The ability to program an overlap between the maximum synchronous rate and the arrhythmias detection rates is a considerable advantage in this setting.
