Mode of Onset of Malignant Ventricular Arrhythmias in Idiopathic Ventricular Fibrillation
Article first published online: 20 APR 2007
Journal of Cardiovascular Electrophysiology
Volume 8, Issue 10, pages 1115–1120, October 1997
How to Cite
VISKIN, S., LESH, M. D., ELDAR, M., FISH, R., SETBON, I., LANIADO, S. and BELHASSEN, B. (1997), Mode of Onset of Malignant Ventricular Arrhythmias in Idiopathic Ventricular Fibrillation. Journal of Cardiovascular Electrophysiology, 8: 1115–1120. doi: 10.1111/j.1540-8167.1997.tb00997.x
- Issue published online: 20 APR 2007
- Article first published online: 20 APR 2007
- Manuscript received 4 April 1997; Accepted for publication 9 July 1997
- ventricular arrhythmias;
- polymorphic ventricular tachycardia;
- sudden death;
- long QT syndrome;
- right ventricular dysplasia;
- electrocardiographic recording;
- electrophysiologic study
Mode of Onset of Idiopathic VF. Introduction: The mode of onset of malignant ventricular arrhythmias (ventricular tachycardia [VT] or ventricular fibrillation [VF] has been well described in patients with organic heart disease and in patients with the long QT syndromes. Less is known about the mode of onset of VF in patients with out-of-hospital VF who have no evidence of organic heart disease or identifiable etiology.
Methods and Results: We reviewed the ECGs of all our patients with Idiopathic VF. Documentation of the onset of spontaneous arrhythmias was available for 22 VK episodes in 9 patients (6 men and 3 women; age 41 ± 16 years). In all instances, spontaneous VF followed a rapid polymorphic VT, which was initiated by premature ventricular complexes (PVCs) with very short coupling intervals. The PVC initiating VF had a coupling interval of 302 ± 52 msec and a prematurity index of 0.4 ± 0.07. These PVCs occurred within 40 msec of the peak of the preceding T wave. Pause-dependent arrhythmias were never observed.
Concltision: Cardiac arrest among patients with idiopathic VF has a very distinctive mode of onset. Documentation of a polymorphic VT that is not pause dependent is of diagnostic value.