Images in Clinical Medicine
Kim Eagle, M.D., Editor
Post-Tachycardia T-Wave Syndrome
N Engl J Med 1995; 332:161January 19, 1995
- Article
Figure 1 Serial electrocardiograms (lead V4) were obtained in a 67-year-old man taking digoxin for paroxysmal supraventricular tachycardia. An electrocardiogram obtained on June 28, 1983, showed no abnormalities. About six weeks later on August 15, while awaiting surgery for peripheral vascular disease, the patient had an episode of paroxysmal supraventricular tachycardia (first electrocardiogram in second row) that responded to carotid-sinus massage. An electrocardiogram obtained shortly after conversion to sinus rhythm showed atrial premature beats and minor T-wave inversions (second electrocardiogram in second row), which became deeper over the next 24 hours (third electrocardiogram in second row). The patient was given verapamil at a dose of 80 mg four times daily. Because of persistent T-wave inversions (recorded on August 17 and 18) he underwent cardiac catheterization and angiography, which revealed normal coronary arteries and normal left ventricular function. The T-wave abnormalities, which are those classically seen in the post-tachycardia syndrome, had decreased by August 25, and he underwent successful femoral-artery bypass surgery. Four years later, in 1987, his electrocardiogram had returned to normal.
Kim Eagle, M.D.
Arnold M. Katz, M.D.
University of Connecticut Health Center School of Medicine, Farmington, CT 06030
