Her ECG showed a wide QRS complex tachycardia with a heart rate of 190 bpm, left bundle branch morphology, and left superior axis.Ī transthoracic echocardiography was performed, which showed a dilated left ventricle, with a severely depressed LVEF of 18% and akinesia of the LV basal posterior wall and severe global hypokinesia.

His cardiovascular risk factors were represented by age > 55 years old, a history of smoking (35 pack-years), and grade 1 overweight. ICD interrogation (Boston Teligen) revealed 34 episodes of sustained monomorphic VT which required ICD intervention: 30 episodes treated with burst ventricular pacing and four episodes requiring internal electrical cardioversion. A 77-year-old male patient with a past medical history of remote infero-lateral myocardial infarction at the age of 56 years treated with thrombolysis, ischemic cardiomyopathy with severe LV systolic dysfunction (LVEF of 30%), severe coronary artery disease (chronic total occlusion of the right coronary artery, chronic total occlusion of the circumflex coronary artery, severe stenosis of the proximal LAD and the first diagonal branch – treated with PTCA and stent implantation at the age of 64 years, intra-stent restenosis of the first diagonal branch treated with PTCA + stent implantation at the age of 69 years), and cardiac arrest at the age of 69 due to ventricular fibrillation with subsequent ICD implantation for the secondary prevention of sudden cardiac death was admitted to the emergency department for electrical storm.

Two dots cheats level 35