Extensive myocardial dystrophic calcification is rare and indicates a poor prognosis with risk of arrhythmia recurrent heart failure. We present long term survivor extensive infarction presenting as related unstable ventricular tachycardia needing an implantable cardioverter defibrillator.

Arrhythmogenic cardiomyopathy is an inherited heart muscle disorder, predisposing to sudden cardiac death, particularly in young patients and athletes. Pathological features include loss of myocytes and fibrofatty replacement of right ventricular myocardium; biventricular involvement is often observed. It is a cell-to-cell junction cardiomyopathy, typically caused by genetically determined abno...

The use of ventricular tachycardia (VT) ablation in patients with structural heart disease remains reserved primarily for those who experience repeated implantable cardioverter defibrillator shocks despite pharmacological and attempted pacing therapy. This fact is confirmed by the comprehensive 8-year report of the experience with VT ablation by the group from the Brigham and Womens’ Hospital.1...

BACKGROUND The number of patients with longer follow-up after implantation of an implantable cardioverter-defibrillator is increasing continuously. Defibrillation lead failure is a typical long-term complication. Therefore, the long-term reliability of implantable cardioverter-defibrillator leads has become an increasing concern. The aim of the present study was to assess the annual rate of tra...

Electrical storm is an increasingly common and life-threatening syndrome that is defined by 3 or more sustained episodes of ventricular tachycardia, ventricular fibrillation, or appropriate shocks from an implantable cardioverter-defibrillator within 24 hours. The clinical presentation can be dramatic. Electrical storm can manifest itself during acute myocardial infarction and in patients who h...

From Duke Clinical Research Institute, Duke University, Durham, N.C. (G.D.S.); the Department of Health Research and Policy, School of Medicine (M.A.H.), and the Center for Primary Care and Outcomes Research, Department of Medicine (M.A.H., D.K.O.), Stanford University, Stanford, Calif.; and the Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (D.K.O.). Address reprint requests ...

Implantable cardioverter-defibrillators (ICDs) have revolutionized the treatment of patients at risk for sudden cardiac death. In the nearly 3 decades since the first human ICD implant,1 millions of devices have been implanted worldwide and innumerable lives have been saved. Successful resuscitation of a potentially lethal ventricular arrhythmia by an ICD system depends on successful arrhythmia...

The need for routine diagnostic tests and procedures needs to be challenged in medical practice, because of continuous pressure to reduce the costs of health care systems. If costs can be minimized by avoidance of routine tests, more sources can perhaps be directed to new advanced diagnostic and therapeutic procedures. This challenge is important particularly in cardiology, because while new di...