Bail-Out of Drug-Refractory VF Electrical Storm in a Patient Who Underwent Percutaneous Coronary Intervention for Three Vessel Disease

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概要

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• Although the prolonged QT interval in a patient with acute coronary syndrome is a predicting factor of lethal ventricular tachyarrhythmia, the relation between revascularization of coronary artery and QT interval is not clear. A 64-year-old man was admitted to the hospital because of congestive heart failure and drug-refractory ventricular fibrillation electrical storm <Vf-ES>. Emergency coronary angiography showed three vessel disease of coronary artery. Percutaneous coronary intervention (PCI) was performed for the culprit lesion of left anterior descending <LAD> artery and revascularized LAD region successfully. However Vf-ES recurred 12 hours after LAD intervention. Therefore, the second PCI was performed for the narrowing of RCA and total occlusion of LCX. Then complete revascularization was obtained. No ventricular tachyarrhythmia was observed after the second procedure. In this patient, QT interval, QT dispersion and Tpeak-end changed dramatically before and after revascularization. The QT interval, QT dispersion, Tpeak-end were 620 msec, 70 msec, 178 msec before PCI, 621 msec, 98 msec, 156 msec after first procedure, and 400 msec, 100 msec, 116 mses after 2nd procedure. The shortening of QT interval and Tpeak-end may be related to complete revascularization and suppression of Vf-ES.

著者

• Kikuchi Miwa

  Division Of Cardiology Department Of Medicine Showa University

• Ito Hiroyuki

  Division Of Applied Bioscience Graduate School Of Agriculture Hokkaido University

• Kobayashi Youichi

  Division Of Cardiology Department Of Internal Medicine Showa University School Of Medicine

• Miyoshi Fumito

  Division Of Cardiology Department Of Internal Medicine Showa University School Of Medicine

• Watanabe Norikazu

  Division Of Cardiology Department Of Internal Medicine Showa University School Of Medicine

• Tanno Kaoru

  Division Of Cardiology Department Of Internal Medicine Showa University School Of Medicine

• Asano Taku

  Division Of Cardiology Department Of Internal Medicine Showa University School Of Medicine

• Watanabe Norikazu

  Division of Cardiology Department of Medicine, Showa University

• Onishi Yoshimi

  Division of Cardiology Department of Medicine, Showa University

• Tanno Kaoru

  Division of Cardiology Department of Medicine, Showa University

• Asano Taku

  Division of Cardiology Department of Medicine, Showa University

• Adachi Taro

  Division of Cardiology Department of Medicine, Showa University

• Kawasaki Shirou

  Division of Cardiology Department of Medicine, Showa University

• Tsujita Hiroaki

  Division of Cardiology Department of Medicine, Showa University

• Hamasaki Yuji

  Division of Cardiology Department of Medicine, Showa University

• Kikuchi Miwa

  Division of Cardiology Department of Medicine, Showa University

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