Multiple ICD shocks in a patient with dilated cardiomyopathy: What is the mechanism?

Abstract

We present the case of a 45-year-old male patient with dilated cardiomyopathy who suffers from multiple implantable cardioverter defibrillator (ICD) shocks. The analysis of the ICD tracing and the electrophysiological study allows to conclude that bundle branch re-entrant tachycardia is the most likely diagnosis, even in absence of conduction abnormalities in his basal electrocardiography.

Keywords: bundle branch re-entrant tachycardia; electrical storm; implantable cardioverter-defibrillator; nonischaemic dilated cardiomyopathy; post pacing interval; ventricular tachycardia.