Aranyo J, Bazan V, Rueda F, Sarrias A, Bisbal F, Villuendas R. Ventricular fibrillation in a patient with Wolff-Parkinson-White syndrome unrelated to pre-excited atrial fibrillation.
Ann Noninvasive Electrocardiol 2019;
24:e12662. [PMID:
31141244 DOI:
10.1111/anec.12662]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 04/09/2019] [Accepted: 04/25/2019] [Indexed: 11/28/2022] Open
Abstract
A 52-year-old man was admitted due to out-hospital cardiac arrest. Recurrent ventricular fibrillation (VF) occurred under therapeutic hypothermia thereafter. Previously inadverted full pre-excitation was documented exclusively and immediately prior to 4 out of the 5 VF relapses. Coronary vasospasm and early repolarization were also documented. An electrophysiological study demonstrated poor anterograde conduction over a left-sided accessory pathway. We theorize that maximum pre-excitation favored in-hospital VF by augmenting the repolarization vulnerability induced by therapeutic hypothermia, with coronary vasospasm accounting as the probable cause of out-hospital VF. A plausible VF mechanism in WPW syndrome unrelated to pre-excited atrial fibrillation is discussed.
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