Double tachycardia following surgery for recurrent ventricular arrhythmias
Coltorti, F.; Ivey, T.D.; Bardy, G.H.; Greene, H.L.
Giornale Italiano di Cardiologia 16(6): 522-526
1986
ISSN/ISBN: 0046-5968 PMID: 3758586 Document Number: 278570
Simultaneous accelerated "junctional" rhythm and atrial flutter were observed postoperatively in a patient who had undergone electrophysiologic surgery for recurrent ventricular fibrillation. Digitalis toxicity was excluded, based on the low serum level of the drug and on the recurrence of the tachycardia after withdrawal of digitalis. While atrial flutter probably represented a postoperative recurrence of a clinically occurring arrhythmia, the accelerated "junctional" rhythm at unusually fast rates most likely developed as a consequence of a cryolesion applied to the ventricular septum as part of the surgical treatment. Phenytoin proved effective in suppressing this "junctional" tachycardia.