<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>The increasing number of patients with heart failure and implantable cardioverter-defibrillators (ICD) has led to a growing of the emergency presentations for ICD internal shocks. Appropriate shocks are sometimes caused by acute events in the course of disease and could be one of the earliest symptoms contributing to the diagnosis and timely treatment of these acute conditions. We present the case of a 64-year-old male patient with ischemic cardiomyopathy, ICD carrier, who presented to the emergency department for recurrent appropriate ICD shocks caused by episodes of polymorphic ventricular tachycardia and ventricular fibrillation. Even if he did not have chest pain, he was referred to cath lab, where the coronary angiography has shown a severe stenosis at the origin of the left anterior descending artery and a moderate stenosis at the proximal left circumflex artery. The percutaneous revascularization of both lesions resulted in the eradication of the sustained ventricular arrhythmias and the improvement of the clinical status. The case argues for the need for coronary vascularization assessment in ICD carrier patients with ischemic heart failure and adequate recurrent shocks, also emphasizing the importance of remote monitoring in early diagnosis of acute conditions in these patients.</p>
</abstract>

The increasing number of patients with heart failure and implantable cardioverter-defibrillators (ICD) has led to a growing of the emergency presentations for ICD internal shocks. Appropriate shocks are sometimes caused by acute events in the course of disease and could be one of the earliest symptoms contributing to the diagnosis and timely treatment of these acute conditions. We present the case of a 64-year-old male patient with ischemic cardiomyopathy, ICD carrier, who presented to the emergency department for recurrent appropriate ICD shocks caused by episodes of polymorphic ventricular tachycardia and ventricular fibrillation. Even if he did not have chest pain, he was referred to cath lab, where the coronary angiography has shown a severe stenosis at the origin of the left anterior descending artery and a moderate stenosis at the proximal left circumflex artery. The percutaneous revascularization of both lesions resulted in the eradication of the sustained ventricular arrhythmias and the improvement of the clinical status. The case argues for the need for coronary vascularization assessment in ICD carrier patients with ischemic heart failure and adequate recurrent shocks, also emphasizing the importance of remote monitoring in early diagnosis of acute conditions in these patients.

Multiple Implantable Cardioverter-Defibrillator Shocks in Ischemic Cardiomyopathy Compels Coronary Vascularization Reassessment

“Iuliu Hațieganu” University of Medicine and Pharmacy

Journal of Cardiovascular Emergencies

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

The increasing number of patients with heart failure and implantable cardioverter-defibrillators (ICD) has led to a growing of the emergency presentations for...

Multiple Implantable Cardioverter-Defibrillator Shocks in Ischemic Cardiomyopathy Compels Coronary Vascularization Reassessment

Published Online: Dec 10, 2023

Page range: 120 - 124

Received: Oct 20, 2023

Accepted: Nov 21, 2023

DOI: https://doi.org/10.2478/jce-2023-0017

Keywords
implantable cardioverter-defibrillator, ischemic cardiomyopathy, acute coronary syndrome, ventricular arrhythmias

© 2023 Gabriel Guşetu et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Multiple Implantable Cardioverter-Defibrillator Shocks in Ischemic Cardiomyopathy Compels Coronary Vascularization Reassessment

Published Online: Dec 10, 2023

Page range: 120 - 124

Received: Oct 20, 2023

Accepted: Nov 21, 2023

DOI: https://doi.org/10.2478/jce-2023-0017

Keywordsimplantable cardioverter-defibrillator, ischemic cardiomyopathy, acute coronary syndrome, ventricular arrhythmias

© 2023 Gabriel Guşetu et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
implantable cardioverter-defibrillator, ischemic cardiomyopathy, acute coronary syndrome, ventricular arrhythmias