about 75 y old patient with known dilatative cardiomyopathy. Condition after implantation of 2-chamber-ICD and several electrophysiological therapies/ ablations in context of recurrent VTs.
Actually the patient was admitted to our ICU with cardial decompensation. In ECG we found a slow VT (heart rate about 110 bpm; VT-detection range of ICD 133/min). The TTE you can see shows a biventricular cardiomyopathie in context of continuous slow VT (this is NO sinus rhythm); beside we see a high-grad insufficiency of mitral valve with reflux into pulmonary veins and a liver congestion. Despite of application of amiodarone and using the ICD (several application of bursts and 30-Joule-cardioversion-shocks via ICD) there was a severe deterioration of the clinical picture. At last we couldn´t rescue the patient.
What do you think? Could it be any other options in this case?