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At cath, he immediately had incessant Torsades de Pointes requiring defibrillation 7 times and requiring placement of a transvenous pacer for overdrive pacing at a rate of 80. Internal potassium balance and the control of the plasma potassium concentration. He was given amiodarone and lidocaine load and drip and K and Mg drips.
CT coronary angiogram showed a hypoplastic RCA and dominant LCx. Most patients can be managed without and implantable cardioverter defibrillator (ICD) In patients with PVCs/VT and a presentation not typical for an idiopathic origin cardiac magnetic resonance (CMR) should be considered, even if the Echo is normal. No PVCs are seen.
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