Case #2
The 33 years old woman (ATS-002), sister of case #1 (ATS-003), was also
invited to our hospital for ATS evaluation. She was asymptomatic.
Frequent bidirectional VT was noted on ECG (Figure 3A). TTE revealed
fair left ventricular systolic function with LVEF at 52%. Metoprolol
was administered and gradually increased to 100 mg daily but her VA was
not significantly reduced. One hundred mg of Flecainide per day was then
added and cardiac monitoring showed ventricular ectopy becoming less
frequent without VT (Figure 3B). Four months after treatment
combination, 24-hours Holter monitoring showed sinus rhythm with
prominent U-wave and occasional ventricular ectopy, and good
biventricular systolic function with trivial mitral valve regurgitation
was observed by TTE.
Similar to her sister, the patient decided to underwent her pregnancy
without medication after extensive discussion with healthcare team. Her
pregnancy was uneventful and she delivered her child successfully. VT
was noticed during postpartum monitoring, therefore, Flecainide and
Metoprolol combination was resumed. Cardiac arrhythmia remained
suppressed at 3 months follow-up visit (Figure 3C).