Philippe Ritter
Ischemic cardiomyopathy
Follow-upvisit
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Philippe Ritter, MD
CHU de Bordeaux
Hôpital Haut Lévêque
Cardiostim Chairman
Philippe Ritter
Ischemic cardiomyopathy
Follow-upvisit
« Quick Look » screen
Battery OK
Leads OK
1 VT/VF treated
Philippe Ritter
Programmable parameters
Philippe Ritter
Fast atrial rate
Slow ventricular rate
VT or VF
ATP
No effect,
VT or VF
2nd ATP
VT Termination
But shock !
Atrial Tachycardia
termination
Episode end
Philippe Ritter
Atrial tachyarrhythmia
Slow ventricular rate
V acceleration
Bi-tachycardiadetected
ATP
Philippe Ritter
Failure of 1st ATP
VF diagnosed
Charge stillgoing
VT stopped
Charge end
Philippe Ritter
Short VV cycles after charge
Sinus rhythmresumes
But inappropriateshock
In VF zone, Charge does not stop after ATP delivery.
When ATP duringchargingisprogrammed, and if 2 short VV cycles occur
after Charge End (CE) beforedetection of slow rhythm,
Charge is Delivered (CD)
If ATP were programmed in the VF zone before charge,
the system would have not shocked.
There would have been redectection after ATP; Sinus rhythmwould
have been diagnosed, and no shockwould have occurred.
However, if VF would not have been terminated by ATP,
shockdeliverywould have been delayed !