Electrical Storms after Levonorgestrel (Synthetic Progestin)-Releasing Intra-Vaginal Device Insertion. A Case Report and a Short Review of Literature

We report a case of arrhythmic storm in a patient with recent vaginal insertion of a device with release of levonorgestrel (synthetic progestin). A woman of 60 years was hospitalized for runs of monomorphic sustained ventricular tachycardia. She received a vaginal device levonorgestrel-releasing 2 days before admission. No history of associated cardiovascular or thyroid disease or risk factors was reported. Laboratory parameters as well as ECG and echocardiogram were normal. After 48 hours from removal of the vaginal device, the patient was asymptomatic and showed only single ectopic beats, sometimes in pairs. The subsequent coronary angiography, electrophysiological study and cardiac magnetic resonance resulted negative.