Volume 71, Issue 2, Pages 142-145 (February 1977) Harbingers of Paroxysmal Ventricular Tachycardia in Acute Myocardial Infarction  Edwin L. Rothfeld, M.D., F.C.C.P., Jeffrey Parsonnet, Wanda McGorman, R.N., Steven Linden, M.D.  CHEST  Volume 71, Issue 2, Pages 142-145 (February 1977) DOI: 10.1378/chest.71.2.142 Copyright © 1977 The American College of Chest Physicians Terms and Conditions

FIGURE 1 Continuous recording obtained in 54-year-old man with acute anterior infarction and atrial fibrillation. Early ventricular premature contraction (“R on T”) initiated sustained paroxysmal ventricular tachycardia that eventually deteriorated to ventricular fibrillation and death despite large intravenous doses of lidocaine and procaine amide (Pronestyl) hydrochloride. CHEST 1977 71, 142-145DOI: (10.1378/chest.71.2.142) Copyright © 1977 The American College of Chest Physicians Terms and Conditions

FIGURE 2 Brief run of paroxysmal ventricular tachycardia begun by very late ventricular premature contraction that is barely premature. This 63-year-old woman with acute inferior infarction had several such episodes that were promptly abolished by administration of lidocaine, and her hospital stay was otherwise uneventful. CHEST 1977 71, 142-145DOI: (10.1378/chest.71.2.142) Copyright © 1977 The American College of Chest Physicians Terms and Conditions

FIGURE 3 Strips A and B were obtained several hours apart during first day of hospitalization of 48-year-old man with acute anteroseptal infarction. In each strip, fourth beat is atrial premature contraction that introduces short episode of paroxysmal ventricular tachycardia. This arrhythmia was easily terminated by therapy with lidocaine, and course of patient's illness while he was hospitalized was benign. CHEST 1977 71, 142-145DOI: (10.1378/chest.71.2.142) Copyright © 1977 The American College of Chest Physicians Terms and Conditions