A CASE OF ACUTE MYOCARDIAL-INFARCTION WITH REENTRANT SUSTAINED VENTRICULAR-TACHYCARDIA DEVELOPING IN THE PREHOSPITAL PHASE

A case of development of monomorphic sustained ventricular tachycardia in the prehospital phase of acute myocardial infarction is reported. By performing pacing from the right ventricular outflow tract during v entricular tachycardia, constant fusion and progressive fusion were do cumented without constant and progressive fusion from the right ventri cular apex pacing, and it was terminated by pacing from the right vent ricular outflow tract. Thus, reentry was considered to be the mechanis m of this ventricular tachycardia occurring in the prehospital phase. Direct angioplasty successfully recanalized the totally occluded coron ary artery, but late potential was present probably because of late re perfusion. In an electrophysiologic study in the chronic phase, slow c onduction areas were found at the interventricular septum and the exit of this ventricular tachycardia was at the mid-septum of the right ve ntricle. A review of the literature failed to reveal any report of a s imilar case.