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It can automatically detect life threatening ventricular arrhythmias and treat them, either with a shock or, sometimes by overdrive pacing. And, after the shock, if there is bradycardia, it can be covered by these two pacing electrodes, one at the tip, and one proximal to it. These are high voltage, defibrillator shock coils.
Ventricular tachycardia is a potentially life threatening cardiac arrhythmia. Polymorphic VT is managed by intravenous magnesium and measures to increase heart rate like pacing as it occurs most often in the setting of bradycardia and QT interval prolongation. If the rate is very fast, hemodynamic deterioration can occur rapidly.
Athlete’s bradycardia due to increased parasympathetic tone and decreased sympathetic tone is a well-known observation. Though sinus bradycardia is usual, other abnormalities like sinus arrhythmia, sinus arrest, wandering atrial pacemaker and coronary sinus rhythm have been described.
But subcutaneous ICD cannot provide bradycardia and antitachycardia pacing as a transvenous ICD. It was a multinational study which enrolled patients at risk for sudden death from ventricular arrhythmias and the follow up period was 6 months. None of the deaths in the study were deemed to be arrhythmia related or procedure related.
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