RECENT ARTICLES summarize the current status of electric countershock in the management of arryhthmias.1,2 Ventricular tachycardia has been induced in a patient by synchronized directcurrent countershocks. Despite prior anticoagulant therapy, the patient also had a peripheral embolization shortly after the restoration of sinus rhythm with electric countershock.
Report of a Case
Rheumatic fever had been diagnosed in this 56-year-old man when he was 9 years of age. A "leakage of the heart" was observed when he was 16 years old. In 1962 he had atypical angina. At that time atrial fibrillation was noted. Protein-bound iodine and radioactive iodine (I131) uptake studies were normal. In 1963 a clearly defined mitral diastolic murmur was heard for the first time. Radiologic study disclosed a moderately enlarged left atrium. One year earlier cardiac fluoroscopy had shown no chamber enlargements.The patient's ventricular rate was controlled with 0.75 mg of gitalin (amorphous ) daily.
Graf WS, Etkins P. Ventricular Tachycardia After Synchronized Direct-Current Countershock. JAMA. 1964;190(5):470–471. doi:10.1001/jama.1964.03070180068019