Sustained accelerated idioventricular rhythm.
A 73-year-old white man became easily fatigued and hypotensive six weeks after a documented acute inferior myocardial infarction. Continuous ECG monitoring showed a sustained tachycardia with a right bundle branch block pattern. A His bundle electrogram showed no His deflection prior to ventricular activation. The patient was successfully treated with intravenous procaine amide resulting in reversion to sinus rhythm, loss of symptoms, and return of blood pressure to normal levels. The unique aspects of this case and therapeutic considerations in the management of this problem are discussed.
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy*; D002037:Bundle-Branch Block / Q000188:drug therapy; D006328:Cardiac Catheterization; D004562:Electrocardiography; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D009203:Myocardial Infarction / Q000150:complications; D011342:Procainamide / Q000008:administration & dosage / Q000627:therapeutic use*; D013610:Tachycardia / Q000188:drug therapy; D013997:Time Factors
D011342:Procainamide