1. Idiopathic ventricular fibrillation or myocardial infarction? Impact of optical coherence tomography on therapeutic decisions

    Idiopathic ventricular fibrillation or myocardial infarction? Impact of optical coherence tomography on therapeutic decisions

    A female patient (47 years old) was referred from a district hospital for Implantable Cardioverter-Defibrillator (ICD) insertion as secondary prevention. Cardiac arrest occurred one week earlier in the course of ventricular fibrillation with an effective defibrillation. It was preceded by the chest pain. ECG showed elevation of ST-segment in inferior leads. Coronary angiography exam did not show stenosis of coronary vessels (Fig. 1A, 1B, 1C). Her medical history revealed mitral and tricuspid valve surgery related to insufficiency 10 years before. No risk factors of ischemic heart disease. While hospitalized she underwent echocardiography, which found akinesis of the basal inferior wall ...

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