Case 93

Abstract

A 62-year-old male had a history of nonischemic cardiomyopathy with a left ventricular ejection fraction of 30%, congestive heart failure (New York Heart Association class II-III), and atrial fibrillation. His rhythm was converted to sinus rhythm with DC cardioversion and maintained with Tikosyn therapy. The cardiomyopathy persisted after optimizing his medical therapy for 3-4 months. Therefore, he received a dual-chamber implantable cardioverter defibrillator, and the device was programmed to suppress the atrial fibrillation by pacing the atrium 10 beats faster than his sinus rate to a maximum of 110 bpm with an AF suppression cycle of 30 beats. He has a first-degree AV block with AV delay of 205 ms, so the sensed AV delay was programmed at 250 ms and the paced AV delay was programmed at 300 ms. © Springer-Verlag London Limited 2011.