A 31-year-old female patient suffering from hemoptysis was scheduled for a lobectomy. Her preoperative electrocardiogram was normal sinus rhythm and electrolytes were within normal range. During mask ventilaton a short run of ventricular tachycardia appeared, but she returned to normal sinus rhythm after lidocaine 60 mg was injected. However, after intubation, sustained ventricular tachycardia developed and did not respond to additional lidocaine immediately. Blood gases and electrolytes were in acceptable range and severe hypotension did not occur during the attack. Several minutes later, the rhythm changed spontaneously to sinus rhythm with intermittent premature ventricular contractions. However, stimuli such as position change and endotracheal suctioning caused another paroxysmal ventricular tachycardia. Idiopathic ventricular tachycardia was suspected and esmolol 30 mg was injected. Ventricular tachycardia terminated abruptly and changed to sinus rhythm so that the lobectomy was done successfully with a continuous infusion of esmolol. We are going to report this clinical experience with review of its mechanism, treatment, and long term prognosis.