ABSTRACT
A 66-year-old woman underwent successful radiofrequency catheter ablation for long-lasting, drug refractory fast atrial flutter. Two days later she had a cardiac arrest due to torsades de pointes (TdP) tachycardia attributed to relative sinus bradycardia and QT interval prolongation. After successful resuscitation further episodes of TdP occurred, which were treated with temporary pacing. Because of concomitant systolic dysfunction due to ischemic and valvular heart disease she was finally treated with an implantable defibrillator. In conclusion we strongly advise prolonged monitoring for 2 or more days for patients with structural heart disease following successful catheter ablation for long lasting tachyarrhythmias.
ABSTRACT
A patient with dilated cardiomyopathy presented at the emergency department with a completely extruded cardiac resynchronization therapy pacemaker, complaining of worsening dyspnea. The device was functioning intermittently, and no evidence of local or systemic inflammation was observed. The patient had been living with the device hanging against his chest for several weeks and he eventually sought medical assistance because of worsening heart failure. The device and leads were extracted, but the patient refused a new implantation at the contralateral site.
