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25-08-2016 | Rhythm Puzzle Question | Uitgave 10/2016 Open Access

Netherlands Heart Journal 10/2016

Incessant ventricular tachycardia

Tijdschrift:
Netherlands Heart Journal > Uitgave 10/2016
Auteurs:
R. Prisecaru, L. Riahi, Y. de Greef, D. Stockman, B. Schwagten
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 The transseptal sheath was withdrawn into the right atrium and afterwards from the right groin.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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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

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