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Gepubliceerd in: Netherlands Heart Journal 10/2016

Open Access 25-08-2016 | Rhythm Puzzle Question

Incessant ventricular tachycardia

Auteurs: R. Prisecaru, L. Riahi, Y. de Greef, D. Stockman, B. Schwagten

Gepubliceerd in: Netherlands Heart Journal | Uitgave 10/2016

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A 65-year-old patient with paroxysmal atrial fibrillation and a normal structural heart underwent cryoballoon pulmonary vein isolation (PVI) under general anaesthesia. After PVI, adenosine 12 mg was given as a rapid intravenous bolus to test each pulmonary vein and no dormant sleeves were documented. The transseptal sheath was withdrawn into the right atrium and afterwards from the right groin. Thereafter, the patient developed pulseless monomorphic ventricular tachycardia (Fig. 1). Subsequently, intravenous injection of amiodarone and a β blocker were administrated and repeated cardiac defibrillations were attempted, but without sustained restoration of sinus rhythm. Inferior ST elevation was also documented.
Coronary angiography revealed diffuse coronary vasospasm (Fig. 2). After intracoronary nitrate infusion, resolution of the coronary vasospasm, complete cessation of the ventricular tachycardia and normalisation of the ST segment were noticed.
Question: What is the underling mechanism of the ventricular tachycardia from Fig. 1?

Answer

You will find the answer elsewhere in this issue.
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
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Metagegevens
Titel
Incessant ventricular tachycardia
Auteurs
R. Prisecaru
L. Riahi
Y. de Greef
D. Stockman
B. Schwagten
Publicatiedatum
25-08-2016
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 10/2016
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-016-0877-8

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