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.
In the VT zone, the programmed therapies are delivered one by one consecutively until the rate falls below the lower limit of the VT zone, or until the end of the programmed therapies. Several sequences of ATP are often programmed, before the delivery of ≥1 shock(s). The first therapy is usually a series of bursts of ATP at fixed cycle lengths. If the bursts are unsuccessful, a series of ramps can be delivered. The ramp automatically decreases the length of consecutive paced cycles in a burst, in programmable steps, which allows a progressive increase in the strength of the therapy delivered.
Three detection zones were programmed. The tachycardia rate was near the upper limit of the VT zone. The combined sudden onset, stability and morphology criteria diagnosed VT. The first 3 bursts of ATP had no effect on the VT. The first sequence of the second set of therapies, a ramp, restored sinus rhythm.
