Successful neural modulation of bedside modified thoracic epidural anesthesia for ventricular tachycardia electrical storm

Figures

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  Figure 1.. (A) Rhythm strip shows a prolonged QT interval with a giant T-wave inversion (blue dotted line) and sudden initiation of ventricular tachycardia. Black arrow indicates first premature ventricular beat inducing ventricular tachycardia. (B) Rhythm strip shows sustained ventricular fibrillation degeneration in the setting of a long QT interval. (C) Rhythm strip shows that the incessant ventricular tachycardia/fibrillation was promptly terminated (asterisk) and restored to a sinus rhythm (blue dotted line) after the thoracic epidural anesthesia. ECG: electrocardiogram.

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  Figure 2.. (A) Intubation tube (black arrow), right jugular vein sheath and defibrillation patch (asterisk) linear thoracic epidural catheter (white arrows). (B) Anatomical position of 18-G Tuohy needle with loss of resistance technique.

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  Figure 3.. (A) A 12-lead electrocardiogram (ECG) shows a prolonged QT interval with a giant T-wave inversion before initiation of ventricular tachycardia at the period of the blue dotted line in Figure 1A. (B) A 12-lead ECG shows normalized QT prolongation with T-wave inversion after the thoracic epidural anesthesia at the period of the blue dotted line in Figure 1C. aVR: augmented vector right; aVL: augmented vector left; aVF: augmented vector foot.