Double sequential cardioversion for refractory ventricular tachycardia: A case report.

Area of Science:

• Cardiology
• Electrophysiology
• Critical Care Medicine

Background:

• Sustained monomorphic ventricular tachycardia (VT) can lead to hemodynamic instability and degenerate into ventricular fibrillation.
• Synchronized cardioversion is the primary treatment for unstable VT with a pulse.
• Refractory VT may necessitate antiarrhythmic drugs like amiodarone, which can exacerbate hypotension.

Observation:

• A case of unstable VT refractory to standard direct current cardioversion is presented.
• Double sequential synchronized cardioversion was employed as an alternative therapeutic strategy.
• The patient experienced rapid conversion to sinus rhythm and achieved hemodynamic stability.

Findings:

• Double sequential synchronized cardioversion effectively terminated refractory VT.
• This technique rapidly restored sinus rhythm and improved hemodynamic status.
• Successful conversion was achieved without the immediate need for hypotensive antiarrhythmic medications.

Implications:

• Double sequential synchronized cardioversion offers a valuable alternative for managing refractory VT.
• This method may prevent medication-induced hypotension in critically ill patients.
• It provides a potentially safer strategy for hemodynamic stabilization in VT emergencies.