Low doses of intravenous epinephrine for refractory sustained monomorphic ventricular tachycardia

Figure 5 Six-lead electrocardiogram from a 47-year-old man in arrhythmic storm with ischemic dilated cardiomyopathy and an implanted cardioverter-defibrillator (patient 3). A sustained ventricular tachycardia (VT) with a heart rate of 140 beats/min is observed, blood pressure (BP) was 90/45 mmHg. intravenous amiodarone failed to terminate VT and decreased BP to 70/40 mmHg. Epinephrine (0.5 mg over 30 s) increased BP up to 125/85 mmHg, and VT terminated within 90 s, preceded by a small shortening of VT cycle length. At the end of the tracing, VT stopped. The bold line on the left side of the picture includes ten VT cycles; the bold line on the right side includes the last ten VT cycles before interruption.