Abstract
B-PO01-106 RECURRENT DEFIBRILLATION FAILURE IN AN ADOLESCENT WITH LEFT VENTRICULAR NON-COMPACTION CARDIOMYOPATHY
Heart rhythm, Vol.18(8), pp.S93-S94
08/2021
DOI: 10.1016/j.hrthm.2021.06.250
Abstract
Background
Left ventricular non-compaction (LVNC) can be associated with ventricular arrhythmias, for which an ICD is indicated. Recurrent defibrillation failure in LVNC has not been reported.
Objective
Report recurrent defibrillation failure in a patient with LVNC.
Methods
NA
Results
A 15 year old boy with LVNC underwent primary prevention S-ICD implant. Defibrillation testing converted VF at 40J. PRAETORIAN score was 45, consistent with the good DFT. At age 19 (57.5 kg, BMI 17.2 kg/m2), he presented with VF and 3 failed maximum energy (80J) S-ICD shocks, converting on the 4 th . Despite more cranial position of the generator than at implant (Figure), S-ICD defibrillation testing was successful at 40J. Given an unexplained clinical failure, the S-ICD was explanted, and a single chamber, single coil transvenous ICD was implanted. Defibrillation testing failed twice at maximum energy (41J), and external defibrillation failed at 125J prior to success at 200J. The single coil lead was removed, and a dual coil lead was implanted, with successful defibrillation at 31J. One year later, he presented with VF and 7 failed maximum energy shocks, converting on the 8 th . A subcutaneous shocking coil was added to the system. Defibrillation was successful at 26J with a “cold can” vector. Sotalol was initiated. Repeat testing in 3 months was again successful at 26J.
Conclusion
This case describes recurrent defibrillation failure via multiple devices in an adolescent patient with LVNC. No other reasons for failure were identified, implicating LVNC as the primary cause. In LVNC, defibrillation testing at ICD implantation may not predict clinical success, even in the absence of known risk factors.
Details
- Title: Subtitle
- B-PO01-106 RECURRENT DEFIBRILLATION FAILURE IN AN ADOLESCENT WITH LEFT VENTRICULAR NON-COMPACTION CARDIOMYOPATHY
- Creators
- Benjamin HaleDavid J. Bradley
- Resource Type
- Abstract
- Publication Details
- Heart rhythm, Vol.18(8), pp.S93-S94
- DOI
- 10.1016/j.hrthm.2021.06.250
- ISSN
- 1547-5271
- eISSN
- 1556-3871
- Language
- English
- Date published
- 08/2021
- Academic Unit
- Stead Family Department of Pediatrics; Cardiology
- Record Identifier
- 9984701839002771
Metrics
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