A surgeon with symptomatic ventricular tachycardia while operating and exacerbated by left lateral decubitus position: Too much of a stretch?

A left lateral body position increases pulmonary vein stress in healthy humans

“…Others similarly have reported that LL position causes an increase in LA dimensions as compared to supine position in younger humans (Khan et al, 2017 , Pump et al, 2002 , Wieslander et al, 2019 ). Also, the left PVs are observed to be larger in LL than in right lateral position, and vice versa (Wieslander et al, 2019 ).…”

Ventricular Tachycardia Storm Originating From Moderator Band Requiring Extracorporeal Membrane Oxygenation

“…The PFs at the MB may have abnormal refractory periods that lead to re-entry, or the PFs may be more susceptible to early afterdepolarizations and subsequently inward calcium current promoting Vas ( 2 ). The latter may be susceptible to stretch and patient position (left lateral decubitus), which was utilized to sustain the VT during our second procedure ( 3 ). In addition to PVC-triggered VF, VT likely degenerated into VF in this case due to profound hypotension and hypoxia in the setting of sustained rapid VT ( 4 ).…”