Monomorphic ventricular tachycardia induced by cardiac resynchronization therapy in patient with severe nonischemic dilated cardiomyopathy.

We report the case of a patient with severe nonischemic dilated cardiomyopathy in whom cardiac resynchronization therapy (CRT) was the source of incessant, drug-resistant, monomorphic ventricular tachycardia (VT). VT recurrences were only resolutive with inactivation of CRT and reactivation of CRT reproduced VT occurrence. The possible pathophysiology of the VT and the potential ventricular proarrhythmic risk related to CRT are discussed. This report points out clearly that CRT can induce ventricular arrhythmias and suggests the need for CRT systematically associated with a defibrillation system.