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J Cardiovasc Electrophysiol. 2010 Feb;21(2):211-3. doi: 10.1111/j.1540-8167.2009.01548.x. Epub 2009 Jul 13.

Electrical storm after CRT implantation treated by AV delay optimization.

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Clinique Pasteur, D├ępartement de Rythmologie, Toulouse, France.


We present a case of symptomatic ischemic heart failure with an indication for cardiac resynchronization and implantable cardiac defibrillator therapy in primary prevention. After implantation, the patient developed a severe electrical storm with multiple shocks. Hemodynamic improvement based only on AV delay, guided by echocardiography and ECG, brought about a dramatic improvement in the situation. We discuss the pathophysiology of electrical storm occurring immediately after LV pacing.

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