Termination of Ventricular Tachycardia by Anti Tachycardia Pacing-An Uncommon Diagnosis on 12 Lead Surface ECG.

Received: 29.05.2016; Revised: 13.01.2017 A 56 years old male had undergone implantation of Dual chamber Automated Implantable Cardioverter Defibrillator (AICD) in November 2011 for documented sustained monomorphic ventricular tachycardia. He was a known case of Ischaemic heart disease (IHD) and had undergone angioplasty with a medicated stent to the mid left anterior descending coronary artery in September 2011. 2 D Echocardiography revealed left ventricular (LV) systolic dysfunction with LV ejection fraction of 35%. There was mild concentric left ventricular hypertrophy with normal chamber d imensions and normal right ventricular function. He had hypertension since four years, which was under control on therapy and was recently detected to have Diabetes mellitus which was controlled with Metformin and diet. He had followed up for symptoms of per rectal bleeding in January 2012 and colonoscopy revealed carcinoma at the junction of rectum and anal canal. This was proven on biopsy. After consultation with an oncosurgeon, it was diagnosed to be in an operable stage and posted for surgery (abdomino –perineal repair ) after high risk informed consent in view of recent angioplasty with a medicated stent and ventricular dysfunction. Fig. 1: Ventricular tachycardia terminated by Anti tachycardia pacing