Slow ventricular tachycardia in a 91-year-old man with implantable cardioverter-defibrillator and acute respiratory failure.

Abstract

Slow ventricular tachycardia (VT) in patients with devices such as an implantable cardioverter - defibrillator (ICD) is more common than in the rest of the population. The incidence in elderly patients with an ICD remains largely unknown. In younger patients, slow VT is generally asymptomatic or associated with limited clinical relevance. It may be efficiently and safely terminated by anti-tachycardia pacing. We present a case of slow VT in a 91-year-old man with ICD with type 1 acute respiratory failure and drowsiness. Very elderly patients who have poor cardiac reserve and minor deterioration in cardiac function can face serious consequences such as ventricular fibrillation, cardiac arrest, and sudden cardiac death. The persistent ventricular rhythm may have a deleterious effect on their haemodynamic status, with potential aggravation of symptoms of heart failure and further impairment of ventricular function.

• Authors: Nicola Vargas, Loredana Tibullo, Cesare A E Landi, Giovanni Carifi, Emanuela Landi, Elisa Salsano, Francesco Di Grezia, Fiore Candelmo
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 35 Issue 8 Pg. 1213.e5-1213.e8 (Aug 2017) ISSN: 1532-8171 [Electronic] United States
• PMID: 28526597 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2017 Elsevier Inc. All rights reserved.

Chemical References

• Hypnotics and Sedatives
• Midazolam

Topics

• Aged, 80 and over
• Continuous Positive Airway Pressure
• Defibrillators, Implantable
• Humans
• Hypnotics and Sedatives (therapeutic use)
• Male
• Midazolam (therapeutic use)
• Respiratory Insufficiency (diagnosis, physiopathology, therapy)
• Sleep Stages
• Tachycardia, Ventricular (diagnosis, physiopathology, therapy)
• Treatment Outcome
• Ventricular Fibrillation (complications, physiopathology, therapy)