[Despite medication, overdrive pacing is required to stabilize the electrical storm associated with acute coronary syndrome: a case report].
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.
Umeda
Masanobu
M
Division of Cardiology, Saiseikai Suita Hospital, Osaka. umedam@tj9.so-net.ne.jp
Morimoto
Atsushi
A
Yokoyama
Kaori
K
Tateishi
Emi
E
Makino
Kanako
K
Yamamoto
Kazuo
K
Nakagawa
Yoko
Y
Fukuhara
Shinya
S
Takase
Eiji
E
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
D000889:Anti-Arrhythmia Agents; D011744:Pyrimidinones; C076259:nifekalant