Cardiac resynchronisation therapy as a cause of the electrical storm

We report a case of young patient with dilated cardiomyopathy and implanted cardioverter-defibrillator in which resynchronisation therapy (CRT-D) induced an electrical storm. One month after implantation of a cardiac resynchronisation pacemaker (CRT-P) the patient suffered from ventricular tachycardia with poor haemodynamic status and was treated by implantation of a CRT-D with a Y adaptor. After replacement of the CRT-D due to Y adaptor damage (new device without a Y adaptor) we observed an electrical storm during ventricular pacing (biventricular, right and left ventricular pacing respectively). Changing pacing mode from DDDR to AAIR resolved ventricular tachycardias in that patient.