An ICD Programming Study for Patients with Electrical Storm after Implantation of Implantable Cardioverter Defib-rillator

WANG Zhao-jun; ZHENG Lei; CHEN Jia-liang; QU Xiu-fen; LI Jing-jie

doi:10.3969/j.issn.1002-3429.2014.09.032

Abstract：Objective To study the implantable cardioverter defibrillator ( ICD) programming setting for patients with electrical storm ( slow ventricular tachycardia, 150-180 bpm) after implantation of ICD. Methods Eleven patients admitted to our hospital emergently with"ventricular electrical storm, slow ventricular tachycardia" after implantation of ICD were ran-domly selected. The ICD or CRTD programming settings were recorded, and routine anti-ventricular tachycardia drugs were given. Anti-tachycardia pacing ( ATP) setting of VT: BURST five times, then SHOCK in vivo without cardioversion ( B5 scheme) or BURST one time, then SHOCK with low energy and no cardioversion ( S1 scheme ) . The B5 scheme and S1 scheme, each worked 24 hours, and then changed to each other. Then we observed the total number of episodes, the total times of B5 scheme and S1 scheme, the success ratio of cardioversion, the ventricular tachycardia time, and the tolerance in patients. Results A total of 188 d were recorded and 94 d each with B5 scheme and S1 scheme. There were 204 times of slow ventricular tachycardia monitored by ICD, among which, 82 times were not treated (3 events stopped before ATP treat-ment), and 122 times were monitored and treated (65 times of B5 scheme and 57 times of S1 scheme). No patient died dur-ing hospitalization. Analysis showed that there was no significant difference in the rates of cardioversion success and SHOCK using between the B5 scheme and the S1 scheme (P>0. 05), but the treatment time was increased in B5 scheme than that in S1 scheme (P <0. 01). Conclusion Patients with ICD implantation during ventricular electrical storm should be pro-grammed individually. Excessive pursuit of ATP painless therapy may increase the risk of heart failure.