Ventricular Tachycardia Storm Originating From Moderator Band Requiring Extracorporeal Membrane Oxygenation

Abstract

A 67-year-old man presented with dizziness secondary to ventricular tachycardia (VT) originating from the moderator band. The VT was refractory to multiple antiarrhythmic medications requiring extracorporeal membrane oxygenation and eventual curative ablation. We highlight a malignant form of idiopathic VT, unique electrocardiogram characteristics, and ablation considerations. ( Level of Difficulty: Intermediate. )

The role of coronary artery disease and revascularization in electrical storm: A multidisciplinary team approach

“…Although it may have contributed in some of the patients, nonischemic substrates need to be considered in the remaining 28% without progressive CAD and even still in those with progressive CAD. VF storm resulting from Brugada syndrome, arrhythmogenic right ventricular cardiomyopathy, long QT syndrome, or idiopathic VF in structurally normal hearts originating from the His-Purkinje system, papillary muscles, or moderator band need to be expeditiously diagnosed via thorough analysis of electrocardiograms, imaging, and clinical history to guide specific unique strategies such as usage of correct medications, atrial pacing, or early ablation [1,8]. In fact, several of these diagnoses were observed in the non-CAD group presenting with ES in the current study and may explain the seemingly low prevalence of progressive CAD in the VF group.…”