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They had a history of non-ischemic cardiomyopathy (EF 30%), as well as PCI with one stent. The WCT is interrupted by a series of variable-morphology QRS complexes, with atrialflutter waves note in II, III, and aVF. The subsequent EP study could not induce VT, only atrial fibrillation.
Whenever I see PVCs with the morphology and axis seen in todays case I always look for signs of AC ( Arrhythmogenic Cardiomyopathy ). Arrhythmogenic cardiomyopathy often manifests with PVCs from the RV. The ECG in Figure-1 however, shows no signs of arrhythmogenic cardiomyopathy. Try a different kind of antiarrhythmic.
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