Rainbow within a storm

T. Joseph*

Consultant Interventional Cardiologist & Electrophysiologist, Kauvery Hospital, Trichy  Heartcity, India

*Correspondence: [email protected]

Case Presentation

  1. A 42 years old male with hamodynamically unstable VT after MI (S/P PTCA to LAD).
  2. DC cardioverted 22 times and on maximal doses of all class of antiarrthymic drugs.
  3. Transferred to Kauvery heart city with ongoing VT storm.
rainbow-within-a-storm-1

Fig. 1. ECG VT with antero apicoseptal exit.

Overnight Emergency ablation

  1. Intubated and under GA patient was taken for emergency ablation with brief activation and substrate mapping of late potentials.
  2. Procedure lasted for 6 h with successful elimination of all potential circuits.
  3. Remained VT free and was walked back home after 3 days.
rainbow-within-a-storm-2

Fig. 2. Rainbow within storm (VT Map).

We map and colour code electrical signal of that VT according to the timing in relation to surface QRS (Fig. 2).

Earliest signal is coded as red and late as blue or violet. We burn that area where its early terminating the focus inside heart which is firing.

Joseph

Dr. T. Joseph

Consultant Interventional Cardiologist & Electrophysiologist

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