PMID- 30546618
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200929
IS  - 1878-5409 (Electronic)
IS  - 1878-5409 (Linking)
VI  - 13
IP  - 4
DP  - 2016 Apr
TI  - Incessant fascicular VT presenting as cardiogenic shock with multi-organ 
      dysfunction syndrome.
PG  - 101-104
LID - 10.1016/j.jccase.2015.11.005 [doi]
AB  - We report a rare clinical presentation of incessant idiopathic fascicular 
      ventricular tachycardia (FVT), presenting as multi-organ dysfunction (MOD) 
      syndrome with cardiogenic shock. Our patient was a 19-year-old male who presented 
      with slowly progressive dyspnea from New York Heart Association (NYHA) II to NYHA 
      IV at the time of presentation, palpitations, and dilated cardiomyopathy due to 
      drug-refractory FVT. The patient was in cardiogenic shock with raised central 
      venous pressures and required inotropic support for maintaining systolic blood 
      pressure above 90 mmHg. The MOD was seen in the form of deranged liver and kidney 
      parameters. Echocardiography showed a dilated left ventricle (LV, 58 mm at 
      end-diastole, 52 mm at end-systole) and decreased ejection fraction (20%). 
      Electrocardiography showed a wide-QRS tachycardia (QRS 140 ms, cycle length 
      440 ms), with RsR' in lead V1 and a QRS axis of -60 degrees . After stabilization with 
      ventilation, inotropic support, and cautious use of diuretics, an 
      electrophysiologic study was performed. A Purkinje potential with early local 
      ventricular activation was recorded from the LV inferoseptal region. The 
      tachycardia was ablated at this site with radiofrequency (RF) energy (40 W for 
      35 sec). Over a 3-month follow-up, the patient remained asymptomatic and the LV 
      size and function returned to normal. <Learning objective: To highlight a rare 
      and unreported complication of fascicular ventricular tachycardia presenting as 
      multi-organ dysfunction and its reversion with radiofrequency ablation.>.
FAU - Thummar, Ankur C
AU  - Thummar AC
AD  - Lokmanya Tilak Municipal Medical College & General Hospitals, Sion, Mumbai, 
      India.
FAU - Patil, Ganesh
AU  - Patil G
AD  - Lokmanya Tilak Municipal Medical College & General Hospitals, Sion, Mumbai, 
      India.
FAU - Khan, Ashar
AU  - Khan A
AD  - Lokmanya Tilak Municipal Medical College & General Hospitals, Sion, Mumbai, 
      India.
FAU - Lokhandwala, Yash Y
AU  - Lokhandwala YY
AD  - Lokmanya Tilak Municipal Medical College & General Hospitals, Sion, Mumbai, 
      India.
FAU - Mahajan, Ajay U
AU  - Mahajan AU
AD  - Lokmanya Tilak Municipal Medical College & General Hospitals, Sion, Mumbai, 
      India.
FAU - Nathani, Pratap J
AU  - Nathani PJ
AD  - Lokmanya Tilak Municipal Medical College & General Hospitals, Sion, Mumbai, 
      India.
LA  - eng
PT  - Journal Article
DEP - 20160207
PL  - Japan
TA  - J Cardiol Cases
JT  - Journal of cardiology cases
JID - 101549579
PMC - PMC6280693
OTO - NOTNLM
OT  - Cardiogenic shock
OT  - Fascicular ventricular tachycardia
OT  - Incessant
OT  - Multi-organ dysfunction syndrome
OT  - Radiofrequency ablation
EDAT- 2016/02/07 00:00
MHDA- 2016/02/07 00:01
PMCR- 2016/02/07
CRDT- 2018/12/15 06:00
PHST- 2015/08/17 00:00 [received]
PHST- 2015/11/17 00:00 [revised]
PHST- 2015/11/25 00:00 [accepted]
PHST- 2018/12/15 06:00 [entrez]
PHST- 2016/02/07 00:00 [pubmed]
PHST- 2016/02/07 00:01 [medline]
PHST- 2016/02/07 00:00 [pmc-release]
AID - S1878-5409(15)00116-4 [pii]
AID - 10.1016/j.jccase.2015.11.005 [doi]
PST - epublish
SO  - J Cardiol Cases. 2016 Feb 7;13(4):101-104. doi: 10.1016/j.jccase.2015.11.005. 
      eCollection 2016 Apr.