Recurrent monomorphic nonsustained ventricular tachycardia in a young pacient – clinical case

Introduction: Ventricular tachyarrhythmias are a seve-re cardiac pathology, with major implications for both patient prognosis and social, due to the fact that these patients make up a population at high risk for sudden death, especially in those with ventricular tachyar-rhythmias with structural abnormalities or those who have developed heart failure. Ventricular tachycardia starts with at least 3-4 consecutive ventricular comple-xes with the same morphology or different morphology but with ventricular origin.

Methods: We present the case of a 19-year old patient known for ventricular extrasystolic arrhythmia and tachyarrhythmia cardiomyopathy who addressed the Cardiology Department of the Clinical Rehabilitation Hospital in Cluj-Napoca for palpitations, dizziness and prelipotimic conditions. We mention that the patient was receiving treatment with 200 mg of Amiodarone and 5 mg of Bisoprolol. The admission clinical exam reveals blood pressure 150/80 mmHg, heart rate of 100 beats / minute, tachycardic cardiac noises, arrhythmic, no heart murmurs, no pulmonary or peripheral stasis. The 12-lead surface electrocardiogram surprised sinus rhythm with 100 beats / minute, coupled ventricular extrasistles. During monitoring of the ECG Holter on a sinus rhythm background, 74579 ventricular extra-sistles (61%) were observed with frequent non-sustai-ned monomorphic ventricular tachycardia episodes. The ablation of ventricular ectopic outbreaks was tried with intra-procedural identification of the origin of arrhythmia in the postero-latero-basal wall of the ri-ght ventricle. Ablation is attempted at this level witho-ut influencing tachyarrhythmia, suggesting a possible epicardial origin, and guiding the pacient towards an epicardial ablation center. In post-ablation Holter ECG monitoring no ventricular extrasystoles or ventricular tachycardia episodes have been observed.

Conclusions: Ventricular tachycardia may occur in patients with a number of ventricular extrasystoles. It may be life-threatening by increasing the risk of sud-den cardiac death. Ablation of ventricular outbreaks is part of the correct management of these pathologies.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)