Myocardial reperfusion may cause profound electrophysiological alterations and can lead to serious reperfusion arrhythmias (RA). Management of RA and the accompanying electrical storm that may occur remains a problem. To our knowledge, the role of balloon re-inflation of the infarct-related artery (IRA) has never been addressed as a treatment modality for RA presenting as ventricular tachycardia (VT) with pulse or supraventricular tachycardia (SVT). Six patients presenting with ST elevation myocardial infarction (STEMI) in the first 12 h, who underwent successful primary percutaneous coronary intervention (PCI), developed RA in the cathlab after restoration of flow in the IRA. The RA was in the form of VT with pulse, except in one patient who had SVT. In four patients, the RA was associated with hemodynamic instability. The mean age of the studied patients was 59.16 ± 7.94 years, and four were males. Coronary artery disease risk factors were prevalent, with four patients being hypertensive, two dyslipidemic, one diabetic, and 2 current smokers. One patient had a history of prior myocardial infarction (MI), and none had a history of congestive heart failure. The coronary angiography showed 100% occlusion of IRA in all patients and 2–3-vessel disease was present in 50%. PCI was successful with restoration of thrombolysis in myocardial infarction (TIMI) 2–3 flow in IRA in all cases. The mean time to revascularization from the onset of chest pain was 4.88 ± 2.68 h. In all cases, balloon re-inflation was successful in terminating the arrhythmias. None of the patients needed direct current cardioversion or anti-arrhythmic drugs for management of the acute arrhythmia. Balloon re-inflation of IRA was successful in terminating RA that develop in the form of VT with pulse or SVT.

中文翻译：

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初次经皮冠状动脉介入治疗中的经皮管理再灌注性心律失常：一例报告

心肌再灌注可能引起深刻的电生理改变，并可能导致严重的再灌注心律不齐（RA）。RA的管理以及随之而来的雷电风暴仍然是一个问题。据我们所知，从未将梗死相关动脉（IRA）球囊再充气的作用作为RA表现为伴有脉搏或室上性心动过速（SVT）的室性心动过速（VT）的治疗方式。在最初的12小时内有6例出现ST抬高型心肌梗死（STEMI）的患者，这些患者接受了成功的一次经皮冠状动脉介入治疗（PCI），在IRA中的血流恢复后，在导管架上出现了RA。除一名患有SVT的患者外，RA呈带脉冲的VT形式。在四名患者中，RA与血流动力学不稳定有关。研究患者的平均年龄为59.16±7.94岁，男性为4名。冠状动脉疾病的危险因素普遍存在，其中四名患者为高血压，两名血脂异常，一名糖尿病患者和两名现时吸烟者。一名患者有既往心肌梗塞（MI）病史，而无充血性心力衰竭史。冠状动脉造影显示，所有患者的IRA均被100％阻塞，而50％的患者存在2–3血管疾病。在所有情况下，PCI均可成功恢复IRA中2–3的心肌梗塞（TIMI）2血栓溶解。从发生胸痛开始进行血运重建的平均时间为4.88±2.68小时。在所有情况下，球囊再通气都能成功终止心律不齐。没有患者需要直流电复律或抗心律不齐药物治疗急性心律失常。