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A 74-year-old woman presented with intermittent chest pain and dyspnea after emotional stress. The electrocardiogram showed sinus rhythm, deep and symmetric T-wave inversion in the anterior leads, and prolonged QT interval (corrected QT: 542 ms) (Figure 1, left). The echocardiogram revealed apical dyskinesia, so the patient was scheduled for early catheterization. Quantitative coronary angiography showed an intermediate tubular stenosis in the mid left anterior descending artery (Figure 1, right, and Supplementary Video), that was further functionally assessed by means of a pressure wire (PressureWire Guidewire, St. Jude Medical, Inc., St. Paul, MN). Baseline fractional flow reserve (FFR) was 0.97. An initial intracoronary adenosine injection of 120 g triggered a presyncopal polymorphic ventricular tachycardia, selflimiting in 12 seconds (Figure 2). A second lower-dose

Fractional flow reserve assessment with adenosine: Be aware of the QT interval