TY - JOUR T1 - Ventricular tachycardia induced by pacing algorithm designed to avoid atrial fibrillation JO - Revista Portuguesa de Cardiologia (English edition) T2 - AU - Roque,David AU - Cabanelas,Nuno AU - Augusto,João AU - Madeira,Francisco AU - Vasconcelos,Hugo AU - Morais,Carlos SN - 21742049 M3 - 10.1016/j.repce.2020.12.005 DO - 10.1016/j.repce.2020.12.005 UR - https://revportcardiol.org/en-ventricular-tachycardia-induced-by-pacing-articulo-S2174204920303597 AB - A patient with a dual chamber pacemaker was admitted to the emergency room after out-of-hospital cardioversion for syncopal sustained monomorphic ventricular tachycardia. Device interrogation revealed an abnormally timed ventricular spike after a ventricular premature beat at the beginning of the event, caused by a pacemaker algorithm designed to avoid atrial fibrillation, non-competitive atrial pacing. Despite the absence of significant coronary lesions, in the setting of a vulnerable substrate – a hypokinetic and hyperechogenic region of ventricular myocardium – an upgrade to a dual-chamber implantable cardioverter-defibrillator was performed, and substrate ablation was planned. ER -