QRS-ST-T triangulation with repolarization shortening as a precursor of sustained ventricular tachycardia during acute myocardial ischemia.
We present segments from a 24-hour 12-lead digital Holter recording in a 48-year-old man demonstrating transient ST elevations in the inferior leads that triggered sustained ventricular tachycardia/ventricular fibrillation (VT/VF) requiring cardioversion. The onset of VT was preceded by a gradual increase in the ST with marked QRS broadening that lacked distinction between the end of the QRS and the beginning of the ST (QRS-ST-T "triangulation"), and shortening of the QT interval not caused by an increased heart rate. This is a relatively rare documentation of the mechanisms immediately triggering sustained ventricular arrhythmias during acute myocardial ischemia obtained with 12-lead ECG.
Cardiovascular and Cell Sciences Research Institute, St. George׳s University of London, Cranmer Terrace, London SW17 0RE, United Kingdom.
Velislav N
VN
Batchvarov
Cardiovascular and Cell Sciences Research Institute, St. George׳s University of London, Cranmer Terrace, London SW17 0RE, United Kingdom.
Elijah R
ER
Behr
Mechanisms of re-entry; Myocardial ischemia; ST segment elevation; Vasospastic angina; Ventricular arrhythmia