PT - JOURNAL ARTICLE AU - Colin Yeo AU - Kelvin CK Wong TI - Recurrent AICD shocks in a 60-year-old man AID - 10.1136/heartjnl-2015-309243 DP - 2016 Aug 15 TA - Heart PG - 1295--1295 VI - 102 IP - 16 4099 - http://heart.bmj.com/content/102/16/1295.short 4100 - http://heart.bmj.com/content/102/16/1295.full SO - Heart2016 Aug 15; 102 AB - Clinical introduction We present the case of a 60-year-old man with history of non-ischaemic cardiomyopathy with left ventricular ejection fraction of 40%. His baseline surface 12-lead ECG shows sinus rhythm with PR interval of 170 ms, no evidence of pre-excitation and a normal QT interval. He had a single-chamber automated implantable cardiac defibrillator (AICD) inserted for sustained wide complex tachycardia associated with palpitations. Subsequently, he presented with recurrent shocks from the AICD coming on at rest despite treatment with amiodarone. He did not experience any significant cardiovascular symptoms except for mild palpitations. There were no reversible causes found for his arrhythmia. Figure 1 shows the device EGM of the event leading to the shock.Question What is the tachycardia that caused the AICD shock? (figure 1) Atrial fibrillation (AF) with pre-excitationVentricular fibrillation (VF)Multiform ventricular tachycardia (VT)Atrial tachycardia (AT) with bundle branch blockTorsades de Pointes (TdP)