VT and the monitor zone - Evera XT VR

Patient

Male implanted with a single-chamber defibrillator (Evera XT VR) for primary prevention of severe dilated cardiomyopathy.


Trace

1-2 What diagnosis is suggested by the interval plot?
The episode was classified as VT-Mon by the device (1); the plot shows a regular tachycardia
in the monitor zone, terminating spontaneously after more than 7 minutes (2)

3- What is your diagnosis?
The EGM showed probable VT in the monitor zone (cycles classified as VS) with spontaneous
reversion.

Take home message

    • This trace shows a VT episode recorded in the monitor zone; in a monitor zone,
      no therapy is programmed.
    • Latest international recommendations favour programming a single VF zone
      for primary prevention with rates > 188 bpm; the aim is to avoid inappropriate
      therapies and focus on treatment of the most serious, life-threatening arrhyth
      mias.
    •  It may also be useful to programme a monitor zone to check for the occurence
      of slower arrhythmias that may warrant treatment.

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