Ventricular fibrillation storm after revascularization of chronic total occlusion of the left anterior descending artery: is this reperfusion arrhythmia?

Figures

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  Figure 1.. ST depression in leads II, III, AVF, and V4 to V6, and qs pattern in leads III, V1, and V2.

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  Figure 2.. (a) Normal left main coronary artery; (b) total occlusion of the proximal left anterior descending artery (LAD); (c) small left circumflex artery (LCX) with diffuse proximal lesions and a maximum diameter of 70%; and (d) diffuse proximal plaques in the right coronary artery (RCA) with a maximum diameter of 80%.

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  Figure 3.. ECG monitoring showed frequent premature ventricular contractions, paroxysmal ventricular tachycardia, and ventricular fibrillation. ECG, electrocardiogram.

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  Figure 4.. Repeat coronary angiography showing well-positioned stents, with no thrombi.

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  Figure 5.. Comparison of the LAD before (left) and after (right) PCI showing compromised collateral circulation between the LCX and LAD, and inadequate flow in the diagonal artery; arrows indicate stenosis in the diagonal artery in both views. LAD, left anterior descending artery; PCI, percutaneous coronary intervention; LCX, left circumflex artery.