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January 30, 1978

Intra-aortic Balloon CounterpulsationRefractory Ventricular Tachycardia

JAMA. 1978;239(5):431-432. doi:10.1001/jama.1978.03280320047021

INTRA-AORTIC balloon counterpulsation (IABCP) is a useful adjunct in the treatment of patients with serious and decompensated cardiac disease. It has been used extensively as an intraoperative and postoperative aid in hemodynamically unstable patients. In addition, it is useful in treating patients with cardiogenic shock following myocardial infarction; however, there have been few reports of its successful use in the management of refractory cardiac arrhythmias.

Report of a Case  A 47-year-old man was admitted to the coronary care unit of another hospital with the complaint of retrosternal chest pain that had persisted for several hours. Serial enzyme determinations and ECGs established the diagnosis of acute anterior septal myocardial infarction. Shortly before discharge, he was awakened with constricting chest pain radiating to the neck. Serial ECGs showed extension of the infarction.Supraventricular tachycardia subsequently developed, which was readily controlled with edrophonium chloride. Recurrent bouts of ventricular tachycardia developed over the following