Percutaneous coronary intervention for ventricular fibrillation in the setting of an anomalous right coronary artery

Figures

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  FIGURE 1. (A) A six‐lead telemetry rhythm strip showing atrial fibrillation with natively conducted QRS complexes, aberrantly conducted QRS complexes, PVCs, and the onset of ventricular fibrillation. (B) Telemetry strip demonstrating ventricular fibrillation.

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  FIGURE 2. (A) Admission EKG, QTc ~431. (B) Post‐arrest EKG, QTc ~554.

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  FIGURE 3. (A) CT‐coronary angiogram demonstrating emergence of an aRCA from the left main. (B) Dedicated RCA view. (C) 3D graphical reconstruction of coronary anatomy with FFR quantitation of coronary flow across proximal aRCA stenosis. FFR of RCA ~0.51.

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  FIGURE 4. (A) Pre‐intervention coronary angiogram demonstrating aRCA emerging from the Left Main and region of narrowing. (B) Pre‐intervention IVUS of proximal aRCA demonstrating ellipse‐like luminal compression with luminal area of 3.4 mm2. Shadowing reflects anatomy of the aortic and pulmonary trunks. (C) Pre‐intervention IVUS of the aRCA distal to proximal narrowing with luminal area of 8.7 mm2.

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  FIGURE 5. (A) Post‐intervention coronary angiogram demonstrating left main, left coronary circulation, and aRCA with resolution of proximal narrowing. (B) Post‐intervention IVUS of proximal aRCA post PCI with rectification of luminal integrity and recovery of luminal area (7 mm2). Shadowing reflects anatomy of the aortic and pulmonary trunks.