A case report of subvutaneous patch polarity implantation was effective against high DFT of LQT Patient

We report a very rare LQT case who had severe high defibrillation threshold (High DFT) and subcutaneous patch polarity implantation was effective against High DFT. The case is a 42 years old woman with past history of mental development and epilepsy. She lost her consciousness suddenly during work and ambulance was called. CPR was started and AED was attached. The rhythm was defined as VF and the first shock could terminate VF. The ECG showed Long QT and we suspected as LQT1 in EPS with epinephrine test. DFT test after ICD implantation was not successful even maximum energy and we needed ten times of electronic shock with DC for the defibrillation. Because it was thought with severe High DFT case, we selected to add a subcutaneous patch polarity as alternative strategy. The DFT reduced remarkably at 10 J and DFT test was successful.