Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jan 26, 2017; 9(1): 71-75
Published online Jan 26, 2017. doi: 10.4330/wjc.v9.i1.71
Optical coherence tomography to identify the cause of an arrhythmic storm: A case report
Etienne L Couture, Simon Bérubé, Benoit Daneault
Etienne L Couture, Simon Bérubé, Benoit Daneault, Division of Cardiology, Centre hospitalier universitaire de Sherbrooke, Sherbrooke J1H 5N4, Canada
Author contributions: All authors contributed to the acquisition of data, writing, and revision of this manuscript.
Institutional review board statement: This case report was exempt from the Institutional Review Board standards at Centre de recherche du centre hospitalier universitaire de Sherbrooke.
Informed consent statement: The patient involved in this study gave her written informed consent authorizing use and disclosure of her protected health information.
Conflict-of-interest statement: All authors have no conflicts of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Benoit Daneault, MD, Division of Cardiology, Centre hospitalier universitaire de Sherbrooke, 12e avenue nord, Sherbrooke J1H 5N4, Canada. benoit.daneault@usherbrooke.ca
Telephone: +1-819-3461110 Fax: +1-819-8206897
Received: June 11, 2016
Peer-review started: June 16, 2016
First decision: July 11, 2016
Revised: September 12, 2016
Accepted: November 16, 2016
Article in press: November 17, 2016
Published online: January 26, 2017
Processing time: 221 Days and 12.4 Hours
Core Tip

Core tip: A 56-year-old man presented to a community hospital after an aborted sudden death. After initial resuscitation, he presented an arrhythmic storm with multiple episodes of ventricular fibrillation refractory to intravenous amiodarone. Coronary angiogram showed a nonobstructive intermediate lesion in the mid left circumflex artery. Because of repeated ventricular fibrillation episodes, an optical coherence tomography (OCT) was performed and revealed a ruptured thin-cap fibroatheroma with an intraluminal thrombosis at the level of the intermediate lesion. This case suggests that performing OCT to detect vulnerable culprit lesion of less than severe angiographic severity when an ischemic event is likely, such as an aborted sudden death or arrhythmic storm, may be of diagnostic value and alter therapeutic decisions.