Postmortem implantable cardioverter defibrillator interrogation

The 78-year-old man described in previous case 169 is followed. No programming was performed at an August 2007 visit. Instead, amiodarone therapy was initiated to prevent asymptomatic VT requiring termination by antitachycardia pacing. Six weeks later, on September 28, 2007, the patient developed rapid palpitations after receiving bad news. Within a few minutes, he experienced dyspnea and his typical angina. He used nitroglycerin spray twice without relief. Twenty minutes later he collapsed and died. Steps that could have been taken to prevent the patient’s death are discussed.