A case of acute myocardial infarction with reentrant sustained ventricular tachycardia developing in the prehospital phase.

A case of development of monomorphic sustained ventricular tachycardia in the prehospital phase of acute myocardial infarction is reported. By performing pacing from the right ventricular outflow tract during ventricular tachycardia, constant fusion and progressive fusion were documented without constant and progressive fusion from the right ventricular apex pacing, and it was terminated by pacing from the right ventricular outflow tract. Thus, reentry was considered to be the mechanism of this ventricular tachycardia occurring in the prehospital phase. Direct angioplasty successfully recanalized the totally occluded coronary artery, but late potential was present probably because of late reperfusion. In an electrophysiologic study in the chronic phase, slow conduction areas were found at the interventricular septum and the exit of this ventricular tachycardia was at the mid-septum of the right ventricle. A review of the literature failed to reveal any report of a similar case.