tag:blogger.com,1999:blog-18943510.post5116034147106628551..comments2023-08-21T02:57:37.362-05:00Comments on Dr. Wes: Case Study: A Case of Recurrent Ventricular TachycardiaDrWeshttp://www.blogger.com/profile/17438019699222125477noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-18943510.post-62833104275761613362013-10-10T16:16:01.362-05:002013-10-10T16:16:01.362-05:00Interesting case. thanks for sharing.Interesting case. thanks for sharing.elizabeth b.noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-49733364251243263512013-10-10T11:53:59.555-05:002013-10-10T11:53:59.555-05:00John -
Good work. This is a rarely described e...John - <br /><br />Good work. This is a rarely described example of ventricular proarrhythmia induced by Medtronic's ventricular rate stabilization algorithm. <br /><br />A few notes about the case. Interval plots like those shown can be helpful to identify the possible mechanism of arrhythmia induction, especially if there is always a pattern of RR intervals that repeats and that DrWeshttps://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-18320812826107405382013-10-10T09:15:23.647-05:002013-10-10T09:15:23.647-05:00Wes,
I think...I hope...
This is MDT's versi...Wes,<br /><br />I think...I hope...<br /><br />This is MDT's version of rate smoothing. They call it rate stabilization. <br /><br />These sorts of extraneous algorithms illustrate my thesis that less is more, even in electrophysiology/pacing. <br /><br />I'm infamous around here for being a non-believer in 'extra' proprietary stuff on cardiac devices. "Turn that $%^& offJohn mandrolahttp://www.drjohnm.orgnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-46424679669827648952013-10-10T07:13:42.893-05:002013-10-10T07:13:42.893-05:00John -
As requested, a bit more information:
Th...John - <br /><br />As requested, a bit more information:<br /><br />The patient's potassium was normal. His EKG showed a prolonged QT interval, but this was thought secondary to Amiodarone which had been started because of recurrent ICD shocks. Mexilentine was also added when Amiodarone failed to be effective at reducing the patient's shock frequency. His ejection fraction was checked DrWeshttps://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-72053658938242807642013-10-10T05:54:44.961-05:002013-10-10T05:54:44.961-05:00I'm studying it Wes.
There is pacing at 740 ...I'm studying it Wes. <br /><br />There is pacing at 740 msec then on the top strip it goes to 1000 msec<br /><br />Perhaps the poly VT is somehow related to the rate changes and pacing. <br /><br />Could we have some other clues, like whether he has some of the wonky proprietary algorithms turned on. Does he have a long QT, low Potassium. <br /><br />Pacing proarrhythmia? <br /><br /><br /><John mandrolahttp://www.drjohnm.orgnoreply@blogger.com