Ventricular electrical storm after Micra™ leadless pacemaker implant

Bert Vandenberk; William Lee; George Veenhuyzen; Glen Sumner; Vikas Kuriachan; Russell F Quinn

doi:10.1016/j.jelectrocard.2021.06.002

Ventricular electrical storm after Micra™ leadless pacemaker implant

J Electrocardiol. 2021 Jul-Aug:67:110-114. doi: 10.1016/j.jelectrocard.2021.06.002. Epub 2021 Jun 12.

Authors

Bert Vandenberk¹, William Lee², George Veenhuyzen³, Glen Sumner³, Vikas Kuriachan³, Russell F Quinn³

Affiliations

¹ Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada; Department of Cardiology, University Hospitals Leuven, Leuven, Belgium. Electronic address: vandenberkbert@gmail.com.
² Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada; University of New South Wales, Sydney, NSW, Australia.
³ Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada.

PMID: 34139617
DOI: 10.1016/j.jelectrocard.2021.06.002

Abstract

Peri- and post-procedural ventricular tachycardia (VT) is a rare complication after leadless pacemaker implantation and requires an individualized approach. In this case report we describe the management of VT in a patient with subendocardial scarring due to prior coronary artery disease who presented with monomorphic VT the day after implant. The etiology was found to be related to the novel ventricular activation wavefront by ventricular pacing which induced a reentrant circuit dependent on pre-existing myocardial substrate. Invasive electrophysiologic study and ablation is a safe and successful treatment strategy in selected patients with evidence of myocardial scarring.

Keywords: Cardiac ablation; Cardiomyopathy; Complication; Leadless pacemaker; Ventricular electrical storm.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Catheter Ablation*
Electrocardiography
Electrophysiologic Techniques, Cardiac
Heart Ventricles
Humans
Pacemaker, Artificial* / adverse effects
Tachycardia, Ventricular* / surgery
Treatment Outcome