title: [Despite medication, overdrive pacing is required to stabilize the electrical storm associated with acute coronary syndrome: a case report].
abstract: 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.
authors.affiliation: Division of Cardiology, Saiseikai Suita Hospital, Osaka. umedam@tj9.so-net.ne.jp
authors.forename: Masanobu
authors.initials: M
authors.lastname: Umeda
authors.forename: Atsushi
authors.initials: A
authors.lastname: Morimoto
authors.forename: Kaori
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Emi
authors.initials: E
authors.lastname: Tateishi
authors.forename: Kanako
authors.initials: K
authors.lastname: Makino
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Yoko
authors.initials: Y
authors.lastname: Nakagawa
authors.forename: Shinya
authors.initials: S
authors.lastname: Fukuhara
authors.forename: Eiji
authors.initials: E
authors.lastname: Takase
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications* / Q000628:therapy*; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004351:Drug Resistance; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000628:therapy; D011744:Pyrimidinones / Q000627:therapeutic use; D015607:Stents; D017180:Tachycardia, Ventricular / Q000209:etiology* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D011744:Pyrimidinones; C076259:nifekalant