[Despite medication, overdrive pacing is required to stabilize the electrical storm associated with acute coronary syndrome: a case report]

J Cardiol. 2007 Oct;50(4):263-9.
[Article in Japanese]

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.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Acute Coronary Syndrome / complications*
  • Acute Coronary Syndrome / therapy*
  • Aged
  • Anti-Arrhythmia Agents / therapeutic use
  • Cardiac Pacing, Artificial / methods*
  • Drug Resistance
  • Female
  • Humans
  • Myocardial Infarction / complications
  • Myocardial Infarction / therapy
  • Pyrimidinones / therapeutic use
  • Stents
  • Tachycardia, Ventricular / etiology*
  • Tachycardia, Ventricular / therapy*
  • Treatment Outcome

Substances

  • Anti-Arrhythmia Agents
  • Pyrimidinones
  • nifekalant