Ventricular fibrillation induced by rapid atrial rates in patients with hypertrophic cardiomyopathy [artículo]
Por: López Gil, María [Cardiología] | Arribas Ynsaurriaga, Fernando [Cardiología].
Colaborador(es): Servicio de Cardiología.
Editor: Europace, 2000Descripción: 2(4):327-332. Tipo de medio: JOUR Recursos en línea: Solicitar documento Resumen: Aims: To describe the mechanisms of induction of ventricular fibrillation (VF) by rapid atrial rates in patients with hypertrophic cardiomyopathy (HCM). Methods: Electrophysiological studies, management and follow-up in three patients with HCM with VF induced by atrial pacing. Results: In one patient, spontaneous sinus tachycardia triggered VF. In another patient, VF occurred after verapamil infusion during rapid atrial fibrillation, and in the remaining patient there was no clinical VF. In all three patients, short runs of atrial pacing (cycle length 272–380 ms) induced VF, and QRS widening preceded fibrillation in all patients. Marked ventricular electrogram fragmentation was documented in one patient during atrial pacing and in another patient during late ventricular extrastimuli. Hypotension was associated with sinus tachycardia in one patient. The two patients developing clinical VF underwent atrioventricular (AV) junctional ablation; a ventricular defibrillator was implanted in one, and a modeswitching dual-chamber pacemaker in the other. No arrhythmic events occurred during 34- and 35-month follow-up, respectively. In the other patient, postatrial fibrillation pauses caused syncope, and he is asymptomatic 52 months after implantation of a dual-chamber pacemaker. Conclusions: Rapid atrial rates can trigger VF in some patients with HCM, probably through a combination of electrophysiological and ischaemic mechanisms. AV junctional ablation may prevent VF in selected cases.Tipo de ítem | Ubicación actual | Signatura | Estado | Fecha de vencimiento |
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Artículo | PC12885 (Navegar estantería) | Disponible |
Navegando Hospital Universitario 12 de Octubre Estantes Cerrar el navegador de estanterías
Formato Vancouver:
López Gil M, Arribas F, García Cosío F. Ventricular fibrillation induced by rapid atrial rates in patients with hypertrophic cardiomyopathy. Europace. 2000;2(4):327-32.
Contiene 19 referencias y 4 figuras
Aims: To describe the mechanisms of induction of ventricular fibrillation (VF) by rapid atrial rates in patients with hypertrophic cardiomyopathy (HCM). Methods: Electrophysiological studies, management and follow-up in three patients with HCM with VF induced by atrial pacing. Results: In one patient, spontaneous sinus tachycardia triggered VF. In another patient, VF occurred after verapamil infusion during rapid atrial fibrillation, and in the remaining patient there was no clinical VF. In all three patients, short runs of atrial pacing (cycle length 272–380 ms) induced VF, and QRS widening preceded fibrillation in all patients. Marked ventricular electrogram fragmentation was documented in one patient during atrial pacing and in another patient during late ventricular extrastimuli. Hypotension was associated with sinus tachycardia in one patient. The two patients developing clinical VF underwent atrioventricular (AV) junctional ablation; a ventricular defibrillator was implanted in one, and a modeswitching dual-chamber pacemaker in the other. No arrhythmic events occurred during 34- and 35-month follow-up, respectively. In the other patient, postatrial fibrillation pauses caused syncope, and he is asymptomatic 52 months after implantation of a dual-chamber pacemaker. Conclusions: Rapid atrial rates can trigger VF in some patients with HCM, probably through a combination of electrophysiological and ischaemic mechanisms. AV junctional ablation may prevent VF in selected cases.
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