Case Presentation:
Our patient was a 33-year-old black female with a past medical history of Brugada syndrome, she had a St Jude Implantable cardiac defibrillator (ICD) implanted in 2009. Despite her ICD placement, subsequent Radiofrequency ablation (RF) ablation in 2013 and quinidine therapy she remained with persistent atrial fibrillation. She presented to the Emergency Department (ED) with complaints of midsternal non-exertional chest pain and shortness of breath. Initial EKG demonstrated atrial fibrillation with controlled ventricular rate and inferior lateral T-wave inversions. Troponin levels were negative. The patient subsequently went into pulseless VT and despite attempted ablation, she remained in VT. She received multiple rounds of CPR with defibrillation until return of spontaneous circulation (ROSC) was achieved. The patient was intubated and placed on ECMO via right femoral access. Cardiothoracic Surgery was consulted to perform a BCSD.