A surgeon with symptomatic ventricular tachycardia while operating and exacerbated by left lateral decubitus position: Too much of a stretch? Faris Khan,

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Presentation transcript:

A surgeon with symptomatic ventricular tachycardia while operating and exacerbated by left lateral decubitus position: Too much of a stretch? Faris Khan, MD, MS, Gregory K. Feld, MD, FHRS, Amir Schricker, MD, FHRS, Frederick T. Han, MD, FHRS, Kurt S. Hoffmayer, MD, FHRS, Jonathan C. Hsu, MD, MAS, FHRS HeartRhythm Case Reports Volume 3, Issue 4, Pages 210-214 (April 2017) DOI: 10.1016/j.hrcr.2017.01.001 Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 1 A: Twelve-lead electrocardiogram showing a ventricular bigeminy pattern on lateral decubitus positioning. B: Telemetry strips showing runs of nonsustained ventricular tachycardia. HeartRhythm Case Reports 2017 3, 210-214DOI: (10.1016/j.hrcr.2017.01.001) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 2 A and B: Patient in the supine position (panel A), with the 12-lead electrocardiogram showing normal sinus rhythm (panel B) with no ectopy. C and D: Patient now in the left lateral recumbent position (panel C), with the 12-lead electrocardiogram showing ventricular bigeminy (panel D). HeartRhythm Case Reports 2017 3, 210-214DOI: (10.1016/j.hrcr.2017.01.001) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 3 A: Twelve-lead electrocardiogram template showing 98% pace-map match. B: CARTO-Paso template showing 98% match. C: Color map showing Paso correlation points (red color with highest correlation). Star (pointed by a chevron) on the fast anatomic map in a right anterior oblique–caudal view shows the best match on the Paso and Bard mapping systems. D and E: CARTO 3-dimensional map with the moderator band (MB; in pink color) and ablation lesions in a right anterior oblique–caudal view (panel D) and in a left anterior oblique view (panel E). The fill threshold was set to 10. HeartRhythm Case Reports 2017 3, 210-214DOI: (10.1016/j.hrcr.2017.01.001) Copyright © 2017 Heart Rhythm Society Terms and Conditions