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

Am J Emerg Med. 2017 Aug;35(8):1213.e5-1213.e8. doi: 10.1016/j.ajem.2017.05.009. Epub 2017 May 11.

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.

Keywords: Elderly adult patients; ICD; Slow ventricular tachycardia.

Publication types

  • Case Reports

MeSH terms

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

Substances

  • Hypnotics and Sedatives
  • Midazolam