Incessant ventricular tachycardia

A 65-year-old patient with paroxysmal atrial fibrillation and a normal structural heart underwent cryoballoon pulmonary vein isolation (PVI) under general anaesthesia. After PVI, adenosine 12 mg was given as a rapid intravenous bolus to test each pulmonary vein and no dormant sleeves were documented. The transseptal sheath was withdrawn into the right atrium and afterwards from the right groin. Thereafter, the patient developed pulseless monomorphic ventricular tachycardia (Fig. 1). Subsequently, intravenous injection of amiodarone and a β blocker were administrated and repeated cardiac defibrillations were attempted, but without sustained restoration of sinus rhythm. Inferior ST elevation was also documented.