Abstract
A 10-year-old girl was admitted to the hospital after experiencing multiple episodes of loss of consciousness due to ventricular tachycardia on the background of congenital long QT syndrome. The patient’s ECG reveals two distinct and unusual features: T wave alternation and 2:1 atrio-ventricular block. After admission, she continued to appear unconscious with monitoring images of ventricular tachycardia and torsades de pointes. The patient was resuscitated and a temporary pacemaker was implanted. Finally, the patient was appointed to implant a dual ICD device. However, when analyzing the device’s tracking, it was found that: Her native rhythm was sinus rhythm with a long QT of 680 ms when the sinus rhythm cycle longer than 1400 ms, its can lead to atrial-ventricular conduction of 2:1. Finally, the VVI anti-bradycardia mode was set to decrease ventricular pacing, which causes biventricular synchronization primitives, as well as the phenomenon of ventricular pacing on the T wave, which causes polymorphic VT. This leads to optimal ICD in minimizing ATP and electrical shock.
