Simultaneous implantable cardioverter defibrillator use in patient previously implanted with a bi-ventricular pacemaker for end-stage heart failure.

We report a case of implantable cardioverter defibrillator (ICD) use after previous biventricular pacemaker insertion for end-stage heart failure. A 75-year-old man with inoperable three-vessel coronary artery disease, per manent atrial fibrillation and end stage heart failure underwent bi-ventric ular pacemaker insertion and His bundle ablation for symptomatic control. N YHA class decreased from class III to II after this procedure. Four months after implant the patient developed paroxysmal sustained, symptomatic ventr icular tachycardia. ICD implantation was undertaken. No potentially serious ICD-pacemaker interaction was noted during subsequent follow-up. We conclude that ICD implantation is feasible after previous bi-ventricular pacemaker insertion, without the need to explant the bi-ventricular pacing device.