Ventricular fibrillation during left ventriculography
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A 56-year-old man presented to the emergency department after 1 hour of sudden-onset chest pain. The initial 12-lead electrocardiogram showed ST-segment elevation and peaked T waves in the anteroseptal leads, which led to concern about acute myocardial infarction (Panel A). Emergency cardiac catheterization revealed an acute occlusion in the proximal left anterior descending artery. A drug-eluting stent was placed, restoring blood flow. The peak creatine kinase level was 4976 U per liter, with an MB index of 5.9%. The peak troponin I level was 115 ng per milliliter. According to our usual practice, routine left ventriculography was performed after stent placement, which showed moderate systolic dysfunction with anterior-wall hypokinesis of the left ventricle; during the procedure, ventricular fibrillation occurred (Panel B, top). The patient's arrhythmia was successfully treated with immediate defibrillation (Panel B, bottom)...

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