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A Perplexing Electrocardiogram

A 72-year-old man was hospitalized with NYHA Class IV congestive heart failure symptoms. In 1995, the patient had undergonecardiomyoplasty procedure for nonischemic cardiomyopathy and advanced systolic heart failure.Subsequently he was implanted with a cardiac Resynchronization Therapy-Defibrillator (Consulta CRT-D,Model number D224TRK,Medtronic, Inc, Minneapolis, MN, USA). On admission, the telemetry recordingand 12 lead ECG demonstrated intermittent high frequency noise as noted in Figures 1 and 2. CRT-D Interrogation showed normal function and normal lead parameters. What is the likely cause of this noise noted on ECG and telemetry?

Credits: Rashmi Hottigoudar,MD, DhanunjayaLakkireddy, MD, Rakesh Gopinathannair,MD, MA

Biosense Webster
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Introduction to AFib
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