A case of refractory ventricular tachycardia successfully treated with a thoracic epidural anesthesia

Abstract

A 34-year-old man with an implantable cardioverter-defibrillator (ICD) to control ventricular tachyarrhythmias arising from a cardiac lipoma developed a ventricular tachycardia (VT) storm. He was deeply sedated and treated with the intravenous administrations of amiodarone, nifekalant, lidocaine, propranolol, and landiolol. Concurrently, he was treated with antitachycardia pacing and direct current cardioversion, but the VT storm continued. Thoracic epidural anesthesia was performed to reduce the sympathetic output to the heart, and the VT storm was completely suppressed. This case suggests that thoracic epidural anesthesia is effective for the treatment of VT storms refractory to medications and catheter ablation.