Chennai hosp performs life-saving procedures on 55-yr-old woman with cardiac arrhythmias
Kauvery Hospital Chennai, a unit of Kauvery Group of Hospitals in Tamil Nadu, successfully performed three life-saving procedures on a 55-year old woman with dangerous cardiac arrhythmias (heart rhythm problems). Radha Balaji, a 55-year-old school teacher, presented to the emergency department with an acute illness. She was diagnosed to be having an acute myocardial infarction (MI; heart attack), complicated by bradycardia (slow heart rate) and cardiogenic shock (failure of the heart to pump blood efficiently to the body, causing the blood pressure to fall to dangerous levels).
She immediately underwent emergency primary angioplasty and stenting to the blocked vessel (right coronary artery). In view of the cardiogenic shock, she required hemodynamic support from an intra-aortic balloon pump (IABP) to safely undergo the procedure. She repeatedly had multiple episodes of ventricular tachycardia (VT), which is a very dangerous heart rhythm abnormality during and after procedure. She needed at least 14 shocks from an external defibrillator.
Speaking on the condition and the multiple procedures, Dr Deep Chandh Raja- Clinical Lead of Cardiac Electrophysiology at Kauvery Hospital Chennai said, “This clinical scenario is called a post-MI VT storm; the patient was very much caught in the eye of the storm. The VT did not revert to normal with medications. Her status was further complicated by the presence of mitral valve prolapse and long QT syndrome (anatomical and electrical abnormalities respectively. Hence, on the 4th day, she was taken for a radiofrequency ablation procedure (a procedure to destroy the cells that cause arrhythmias) at the Hybrid Cath Lab operating room. An advanced 3-dimensional navigation system was used to find the source that was triggering the ventricular tachycardia. After a 6-hour long and arduous procedure she was made free of the VT. Her blood pressure and hemodynamics promptly improved. As she had a predisposition to dangerous heart rhythms, she also received implantation of a percutaneous defibrillator on the next day to protect her from such episodes in the future. She underwent cardiac rehabilitation during the following days in the hospital with graded mobilisation and nutrition. On day 14, she was discharged from the hospital and was home.”
Dr Sundar C, Senior Consultant Interventional Cardiologist, said, “Timely angioplasty saved her from a massive heart attack and cardiogenic shock. It was a difficult situation when she also had a VT storm during and after procedure, which was due to her inherent long QT Syndrome. The Cardiac Electrophysiologist ensured that the patient had no more VT by performing the ablation procedure.”