A 68-year-old man with ischemic cardiomyopathy (NYHA Class II, left-ventricular ejection fraction 26%) underwent implantation of a prophylactic dual-chamber ICD (Medtronic EnTrust™ D154ATG) 2 years ago. His medications include lisinopril 20 mg daily, carvedilol 12.5 mg daily, simvastatin 40 ms daily, and aspirin 325 mg daily. The ICD was programmed for single zone detection as shown in the upper panel of Fig. 110.1. Six months ago, he had presyncope followed by a shock. ICD interrogation showed ineffective antitachycardia pacing followed by a successful shock for VT with AV dissociation at cycle length 240 ms.
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