Inappropriate ICD Shocks Due to the Recovery of AV Conduction by Prednisolone in a Patient With Cardiac Sarcoidosis

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We report the case of a patient with suspected cardiac sarcoidosis who recovered the atrioventricular (AV) conduction from complete AV block after the administration of prednisolone and had inappropriate shock delivers from implantable cardioverter-defibrillator (ICD) due to sinus tachycardia. A58-year-old man was taken to the emergency room because of repetitive ICD delivers. He underwent implanted a dual-chamber pacemaker for complete AV block 12 yeas ago. He was upgraded to ICD and started taking amiodarone for sustained ventricular tachycardia (VT) eight months before the delivery to the emergency room. He was suspected as cardiac sarcoidosis but rejected the administration of prednisolone. He was stopped amiodarone and finally administrated prednisolone for severe pulmonary fibrosis one month before the event. He experienced repetitive ICD delivers during walking outside. The electrograms (EGMs) of ICD indicated the inappropriate shocks because of sinus tachycardia and recovery of AV conduction from complete AV block. He has had none of inappropriate ICD shocks after the adjustment of the detection of ICD for VT.

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