Termination of Idiopathic Sustained Monomorphic Ventricular Tachycardia by Synchronized Electrical Cardioversion during Pregnancy

• Published in: Acute and critical care Vol. 33; no. 1; pp. 46 - 50
• Main Author: Lee, Sungmin
• Format: Journal Article
• Language: English
• Published: Korean Society of Critical Care Medicine 01.02.2018; 대한중환자의학회
• Subjects: Case Report; electric countershock; pregnancy; tachycardia, ventricular; 마취과학
• ISSN: 2586-6052; 2586-6060
• DOI: 10.4266/acc.2016.00115

The most common cardiac complications detected during pregnancy are an arrhythmia. However, idiopathic continuous monomorphic ventricular tachycardia (VT) during pregnancy is unusual. A 31-year-old pregnant woman presented at 20 weeks of gestation with progressive palpitation and episodes of agitation. An initial 12-lead electrocardiogram (ECG) showed normal sinus rhythm. However, 30 minutes after presenting at the emergency room, she complained of chest pain. A subsequent ECG showed wide complex monomorphic VT. We attempted to administer an antiarrhythmic drug, but the patient refused any medication because of concerns regarding possible adverse effects on the fetus. Therefore, we performed synchronized electrical cardioversion eight times. After the eighth synchronized cardioversion at 200 J, the ECG showed successful restoration of sinus rhythm. The condition of the fetus was monitored via ultrasonography and cardiotocography, and no adverse events were observed. We present the case of a successful synchronized electrical cardioversion performed in a woman at 20 weeks of gestation because of sustained symptomatic VT.