CASE REPORT

How To Treat: Idiopathic Left Ventricular Tachycardia and Acute Myocardial Infarction?
Lumentut GP, Sumampouw TJ, Gunawan EJ, Setiadi B, Pangemanan JA, Panda AL
gracelumentut88@gmail.com

Abstract
Introduction
Ventricular Tachycardia (VT) is often considered a life-threatening arrhythmia. Idiopathic Left
Ventricular Tachycardia (ILVT) accounts for 10–15% of all VT. Patient presenting with VT and
an Acute Myocardial Infarction (AMI) are a group that has a significantly increased risk of
mortality. This case reporting a 59-year-old female with a history of palpitations and chest
discomfort presented to the emergency department. Clinical examination was unremarkable,
except a heart rate of 166 beats/min. Electrocardiography (ECG) showed a pattern of ILVT.
Laboratory examination showed increase in Troponin T level.
Objectives
To determine the cause and therapeutic options of ILVT in this patient.
Methods
Early medication such as dual antiplatelet and calcium channel blocker was given, and a
synchronized cardioversion was done due to persistent ventricular arrhythmia. Diagnostic
work up such as echocardiography and coronary angiography was conducted.
Results
ECG after synchronized cardioversion showed normal sinus rhythm. Echocardiography
showed reduced left ventricular ejection fraction (LVEF) of 41%, with regional wall motion
abnormalities in anterior and anteroseptal. The coronary angiography showed diffuse stenosis
85%-90% proximal to distal Left Anterior Descending (LAD), diffuse stenosis 75% distal Left
Circumflex Artery (LCX), diffuse stenosis 75% proximal to mid Right Coronary Artery (RCA).
Considering the results, percutaneous coronary intervention (PCI) of LAD and RCA was done.
After successful coronary angiography and stenting, patient had no episode of recurrent ILVT.
Patients was kept on dual antiplatelet therapy, statin and beta-blocker. Her follow up after PCI
was uneventful and she was discharged 7 days after.
Conclusion
In patient with acute ischemia, the ventricular tachycardia is reversible with coronary
revascularization.

Keywords: Idiopathic Left Ventricular Tachycardia, Acute Myocardial Infarction.

Figure 1. Patient ECG