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Ineffective ICD Shocks for Ventricular Fibrillation in a Patient with a Left Ventricular Assist Device: Continuous Flow during the Electrical Storm


Ventricular arrhythmias can be life-threatening and serve as a precursor to sudden death. They are a common presentation in patients with a severely reduced left ventricular function. The use of implantable cardioverter defibrillators (ICD) is seen as an acceptable therapy against malignant ventricular arrhythmias, however ineffective, or inappropriate treatments have been reported in a small subset of patients. Left ventricular assist devices (LVAD) can assist patients with left ventricular heart failure by providing pulsatile flow to mimic cardiac systolic and diastolic function. We report a case of a 38-year-old male with a LVAD who presented to the emergency department following a syncopal episode after frequent discharges of his ICD. Documented episodes of VF were observed with a failed follow-up defibrillator threshold test.

Credits: Enes Elvin Gul, MD; Mohammad Melhem, MD; Sohaib Haseeb, BSc; Rifat Al Harshi, MD; Osama el Amudi MD



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