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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 74-year-old woman presented with intermittent chest pain and dyspnea after emotional stress&#46; The electrocardiogram showed sinus rhythm&#44; deep and symmetric T-wave inversion in the anterior leads&#44; and prolonged QT interval &#40;corrected QT&#58; 542 ms&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#44; left&#41;&#46; The echocardiogram revealed apical dyskinesia&#44; so the patient was scheduled for early catheterization&#46; Quantitative coronary angiography showed an intermediate tubular stenosis in the mid left anterior descending artery &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#44; right&#44; and <a class="elsevierStyleCrossRef" href="#sec0035">Supplementary Video</a>&#41;&#44; that was further functionally assessed by means of a pressure wire &#40;PressureWire&#8482; Guidewire&#44; St&#46; Jude Medical&#44; Inc&#46;&#44; St&#46; Paul&#44; MN&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Baseline fractional flow reserve &#40;FFR&#41; was 0&#46;97&#46; An initial intracoronary adenosine injection of 120 &#956;g triggered a presyncopal polymorphic ventricular tachycardia&#44; self-limiting in 12 seconds &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>&#41;&#46; A second lower-dose injection of 60 &#956;g was followed by another episode of non-sustained polymorphic VT&#46; Then atropine 1 mg was administered intravenously&#44; heart rate increased above 80 beats per minute&#44; and further adenosine boluses &#40;up to 240 &#956;g&#41; were well tolerated&#46; Minimum FFR was 0&#46;93&#44; so intervention was safely deferred&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Adenosine has largely replaced papaverine as the hyperemic agent of choice due to anecdotal evidence of ventricular arrhythmias with the latter&#46; However&#44; in patients with long QT interval adenosine may not be so safe&#44; as it can promote triggered activity and precipitate ventricular tachycardia&#46; A long QT interval is frequently seen in patients with stress cardiomyopathy&#46; In these cases&#44; premedication with atropine or determination of adenosine-free indices such as the instantaneous wave-free ratio can increase the safety of functional assessment of coronary stenosis&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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