A 75-year-old female complained of severe chest pain and was emergently admitted to our hospital because of anterior acute myocardial infarction. Emergent coronary angiography was performed and revealed occlusion in segment 7, so a stent was implanted. Lidocaine, carvedilol, amiodarone, magnesium, and nifekalant were administered successively because non-sustained ventricular tachycardia (NSVT) frequently appeared like an electrical storm. After nifekalant administration, QTc was significantly prolonged and torsades de pointes was induced. Overdrive pacing was performed and finally the NSVT was completely controlled. If fatal arrhythmias such as NSVT show resistance to medication, overdrive pacing should be considered to stabilize the arrhythmia associated with acute coronary syndrome.
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Indian Pacing Electrophysiol J
December 2024
Department of Cardiology, FEHI, Okhla, New Delhi, India.
J Med Case Rep
December 2024
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia.
Background: This case highlights the management of concomitant acute myocarditis and congenital long QT syndrome with electrical storm and incessant Torsade de Pointes.
Case Presentation: An 18 years-old Southeast Asian para 1 abortus 0 (P1A0) postpartum patient with cesarean section owing to severe preeclampsia, acute lymphocytic myocarditis, and prolonged QT interval owing to long QT syndrome. She has incessant Torsade de Pointes treated with beta-blocker, lidocaine, overdrive pacing with a temporary transvenous pacemaker, left cardiac sympathetic denervation per video-assisted thoracoscopic surgery, and implantable cardioverter-defibrillator implantation.
Heart Rhythm
November 2024
University of Alabama at Birmingham, Birmingham, Alabama; VA Health Care System, Birmingham, Alabama. Electronic address:
Eur Heart J
December 2024
Hôpital Cardiologique Haut Lévêque, CHU Bordeaux, Avenue de Magellan, 33604 Pessac, France.
In the case of adenosine-sensitive atrial tachycardia originating near the atrioventricular (AV) node, overdrive pacing from the anterior right atrium showed constant and progressive fusion, indicating that the pacing site is proximal to slow conduction. Shortening the pacing cycle length prolonged conduction times to the orthodromic capture sites; they remained unchanged at the antidromic capture sites. Limited decremental conduction property in the slow conduction zone supports the hypothesis that AV node-like tissue remnants along the AV annulus are involved.
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