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Published on: June 29, 2022
Temporary atrial overdrive pacing during a drug-refractory electrical storm in acute myocardial infarction
Markéta Chalupová1, Philipp Suter2, Denis Graf1
1Department of Cardiology, HFR Fribourg Hôpital Cantonal, Fribourg, Switzerland.
Abstract:
A 64-year-old man with diabetes mellitus was diagnosed with a non-ST-segment elevation myocardial infarction and was treated with stent implantation. Four days later, he developed an electrical storm (ES) that persisted despite antiarrhythmic drugs and sedation. External defibrillation was performed more than 100 times over 2 hours. After ruling out the common causes of polymorphic ventricular tachycardia, an ES was considered because of brady-dependent R-on-T phenomenon, presumably precipitated by antiarrhythmic drugs. Temporary transvenous atrial overdrive pacing allowed complete suppression of premature ventricular complexes and ventricular fibrillation.
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