Treatment of Recurrent LV Tachycardia Through LV Aneurysmectomy Procedure

The present study highlights the treatment of recurrent LV tachycardia through LV aneurysmectomy procedure. The aneurysm may be asymptomatic or present as heart failure, sustained ventricular tachyarrhythmias, or arterial embolism. Left ventricular aneurysm (LVA) is one of the common complications of myocardial infarction (MI) that can lead to death or serious morbidity [1]. We present a 71 YO woman PMH of CAD S/P LAD stent, HTN, DLD, RA myxoma, LV apical thrombus, s/p cardiac arrest and s/p single-chamber implantable cardioverter-defibrillator (ICD) on Mexiletine, who presented to hospital with multiple ICD shocks. Initial EKG showed a wide complex rhythm with an LBBB pattern. Amiodarone was administered to the patient, and mexiletine was continued. Temporarily covering the ICD with a magnet helped to prevent more shocks. Overdrive pacing attempts during wide complex tachycardia were unsuccessful. During this admission, no serious infections or anomalies related to electrolytes were found. This admission's Echo as well as the previous admission's ECHO both revealed aneurysmal malformation and LV apical dyskinesis. The resolution of her arrhythmia was achieved only after an aneurysmectomy.