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Verheul LM, Groeneveld SA, Stoks J, Hoeksema WF, Cluitmans MJM, Postema PG, Wilde AAM, Volders PGA, Hassink RJ. The Dutch Idiopathic Ventricular Fibrillation Registry: progress report on the quest to identify the unidentifiable. Neth Heart J 2024:10.1007/s12471-024-01870-y. [PMID: 38653923 DOI: 10.1007/s12471-024-01870-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Idiopathic ventricular fibrillation (iVF) is a rare cause of sudden cardiac arrest and, by definition, a diagnosis of exclusion. Due to the rarity of the disease, previous and current studies are limited by their retrospective design and small patient numbers. Even though the incidence of iVF has declined owing to the identification of new disease entities, an important subgroup of patients remains. AIM To expand the existing Dutch iVF Registry into a large nationwide cohort of patients initially diagnosed with iVF, to reveal the underlying cause of iVF in these patients, and to improve arrhythmia management. METHODS The Dutch iVF Registry includes sudden cardiac arrest survivors with an initial diagnosis of iVF. Clinical data and outcomes are collected. Outcomes include subsequent detection of a diagnosis other than 'idiopathic', arrhythmia recurrence and death. Non-invasive electrocardiographic imaging is used to investigate electropathological substrates and triggers of VF. RESULTS To date, 432 patients have been included in the registry (median age at event 40 years (interquartile range 28-52)), 61% male. During a median follow-up of 6 (2-12) years, 38 patients (9%) received a diagnosis other than 'idiopathic'. Eleven iVF patients were characterised with electrocardiographic imaging. CONCLUSION The Dutch iVF Registry is currently the largest of its kind worldwide. In this heterogeneous population of index patients, we aim to identify common functional denominators associated with iVF. With the implementation of non-invasive electrocardiographic imaging and other diagnostic modalities (e.g. echocardiographic deformation, cardiac magnetic resonance), we advance the possibilities to reveal pro-fibrillatory substrates.
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Affiliation(s)
- Lisa M Verheul
- Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands.
| | - Sanne A Groeneveld
- Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Job Stoks
- Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Wiert F Hoeksema
- Department of Cardiology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, The Netherlands
| | - Matthijs J M Cluitmans
- Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Pieter G Postema
- Department of Cardiology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, The Netherlands
| | - Arthur A M Wilde
- Department of Cardiology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, The Netherlands
| | - Paul G A Volders
- Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Rutger J Hassink
- Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands
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Verheul LM, Hoeksema WF, Groeneveld SA, Mulder BA, Bootsma M, Alings M, Evertz R, Blank AC, Kammeraad JAE, Clur SAB, Yap SC, Postema PG, Wilde AAM, Volders PGA, Hassink RJ. Comparing adolescent- and adult-onset unexplained cardiac arrest: Results from the Dutch Idiopathic VF Registry. Heart Rhythm 2024:S1547-5271(24)00276-5. [PMID: 38493994 DOI: 10.1016/j.hrthm.2024.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/22/2024] [Accepted: 03/11/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Current cohorts of patients with idiopathic ventricular fibrillation (IVF) primarily include adult-onset patients. Underlying causes of sudden cardiac arrest vary with age; therefore, underlying causes and disease course may differ for adolescent-onset vs adult-onset patients. OBJECTIVE The purpose of this study was to compare adolescent-onset with adult-onset patients having an initially unexplained cause of VF. METHODS The study included 39 patients with an index event aged ≤19 years (adolescent-onset) and 417 adult-onset patients from the Dutch Idiopathic VF Registry. Data on event circumstances, clinical characteristics, change in diagnosis, and arrhythmia recurrences were collected and compared between the 2 groups. RESULTS In total, 42 patients received an underlying diagnosis during follow-up (median 7 [2-12] years), with similar yields (15% adolescent-onset vs 9% adult-onset; P = .16). Among the remaining unexplained patients, adolescent-onset patients (n = 33) had their index event at a median age of 17 [16-18] years, and 72% were male. The youngest patient was aged 13 years. In comparison with adults (n = 381), adolescent-onset patients more often had their index event during exercise (P <.01). Adolescent-onset patients experienced more appropriate implantable cardioverter-defibrillator (ICD) therapy during follow-up compared with adults (44% vs 26%; P = .03). Inappropriate ICD therapy (26% vs 17%; P = .19), ICD complications (19% vs 14%; P = .41), and deaths (3% vs 4%; P = 1) did not significantly differ between adolescent-onset and adult-onset patients. CONCLUSION IVF may occur during adolescence. Adolescent-onset patients more often present during exercise compared with adults. Furthermore, they are more vulnerable to ventricular arrhythmias as reflected by a higher incidence of appropriate ICD therapy.
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Affiliation(s)
- Lisa M Verheul
- University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Wiert F Hoeksema
- Amsterdam UMC location University of Amsterdam, Department of Cardiology, Heart Failure and Arrhythmias, Amsterdam, The Netherlands, Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, The Netherlands
| | | | - Bart A Mulder
- University Medical Center Groningen, Groningen, The Netherlands
| | | | | | - Reinder Evertz
- Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Janneke A E Kammeraad
- Erasmus MC-Sophia Children's Hospital, Cardiovascular Institute, Department of Pediatric Cardiology, Rotterdam, The Netherlands
| | - Sally-Ann B Clur
- Amsterdam UMC location University of Amsterdam, Department of Cardiology, Heart Failure and Arrhythmias, Amsterdam, The Netherlands, Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, The Netherlands; Member of the European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart: ERN GUARD-Heart,"
| | - Sing-Chien Yap
- Cardiovascular Institute, Thorax Center, Erasmus MC, Rotterdam, The Netherlands
| | - Pieter G Postema
- Amsterdam UMC location University of Amsterdam, Department of Cardiology, Heart Failure and Arrhythmias, Amsterdam, The Netherlands, Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, The Netherlands; Member of the European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart: ERN GUARD-Heart,"
| | - Arthur A M Wilde
- Amsterdam UMC location University of Amsterdam, Department of Cardiology, Heart Failure and Arrhythmias, Amsterdam, The Netherlands, Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, The Netherlands; Member of the European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart: ERN GUARD-Heart,"
| | - Paul G A Volders
- Member of the European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart: ERN GUARD-Heart,"; Maastricht University Medical Center, Maastricht, The Netherlands
| | - Rutger J Hassink
- University Medical Center Utrecht, Utrecht, The Netherlands; Member of the European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart: ERN GUARD-Heart,"
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Verheul LM, Guglielmo M, Groeneveld SA, Kirkels FP, Scrocco C, Cramer MJ, Bootsma M, Kapel GFL, Alings M, Evertz R, Mulder BA, Prakken NHJ, Balt JC, Volders PGA, Hirsch A, Yap SC, Postema PG, Nijveldt R, Velthuis BK, Behr ER, Wilde AAM, Hassink RJ. Mitral Annular Disjunction in Idiopathic Ventricular Fibrillation Patients: Just a Bystander or a Potential Cause? Eur Heart J Cardiovasc Imaging 2024:jeae054. [PMID: 38412329 DOI: 10.1093/ehjci/jeae054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/25/2024] [Accepted: 02/12/2024] [Indexed: 02/29/2024] Open
Abstract
AIMS Previously, we demonstrated that inferolateral mitral annular disjunction (MAD) is more prevalent in patients with idiopathic ventricular fibrillation (IVF) than in healthy controls. In the present study, we advanced the insights into the prevalence and ventricular arrhythmogenicity by inferolateral MAD in an even larger IVF cohort. METHODS AND RESULTS This retrospective multicentre study included 185 IVF patients (median age 39 [27, 52] years, 40% female). Cardiac magnetic resonance images were analysed for mitral valve and annular abnormalities and late gadolinium enhancement. Clinical characteristics were compared between patients with and without MAD. MAD in any of the 4 locations was present in 112 (61%) IVF patients and inferolateral MAD was identified in 24 (13%) IVF patients. Mitral valve prolapse (MVP) was found in 13 (7%) IVF patients. MVP was more prevalent in patients with inferolateral MAD compared with patients without inferolateral MAD(42% vs. 2%, p < 0.001). Proarrhythmic characteristics in terms of a high burden of premature ventricular complexes (PVC) and non-sustained ventricular tachycardia (VT) were more prevalent in patients with inferolateral MAD compared to patients without inferolateral MAD (67% vs. 23%, p < 0.001 and 63% vs 41%, p = 0.046, respectively). Appropriate implantable cardioverter defibrillator therapy during follow-up was comparable for IVF patients with or without inferolateral MAD (13% vs. 18%, p = 0.579). CONCLUSION A high prevalence of inferolateral MAD and MVP is a consistent finding in this large IVF cohort. The presence of inferolateral MAD is associated with a higher PVC burden and non-sustained VTs. Further research is needed to explain this potential interplay.
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Affiliation(s)
- L M Verheul
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - M Guglielmo
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - S A Groeneveld
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - F P Kirkels
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - C Scrocco
- Cardiology Research Section, St. George University of London, Cranmer Terrace, London, SW17 0RE and St George's University Hospitals NHS Foundation Trust, London, SW17 0QT United Kingdom
| | - M J Cramer
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - M Bootsma
- Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - G F L Kapel
- Medisch Spectrum Twente, Koningstraat 1, 7512 KZ, Enschede, The Netherlands
| | - M Alings
- Amphia Hospital, Molengracht 21, 4818 CK, Breda, The Netherlands
| | - R Evertz
- Radboud UMC, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen
| | - B A Mulder
- University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - N H J Prakken
- University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - J C Balt
- St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands
| | - P G A Volders
- Maastricht University Medical Center+, Peter Debyelaan 25, 6229 HX, Maastricht, The Netherlands
- Member of the European Reference Network for rare, low prevalence and complex diseases of the heart: ERN GUARD-Heart" (http://guardheart.ern-net.eu)
| | - A Hirsch
- Erasmus MC, Cardiovascular Institute, Thorax Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
| | - S C Yap
- Erasmus MC, Cardiovascular Institute, Thorax Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
| | - P G Postema
- Amsterdam UMC location University of Amsterdam, Department of Cardiology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, the Netherlands
- Member of the European Reference Network for rare, low prevalence and complex diseases of the heart: ERN GUARD-Heart" ( http://guardheart.ern-net.eu)
| | - R Nijveldt
- Radboud UMC, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen
| | - B K Velthuis
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - E R Behr
- Cardiology Research Section, St. George University of London, Cranmer Terrace, London, SW17 0RE and St George's University Hospitals NHS Foundation Trust, London, SW17 0QT United Kingdom
| | - A A M Wilde
- Amsterdam UMC location University of Amsterdam, Department of Cardiology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, the Netherlands
- Member of the European Reference Network for rare, low prevalence and complex diseases of the heart: ERN GUARD-Heart" ( http://guardheart.ern-net.eu)
| | - R J Hassink
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Member of the European Reference Network for rare, low prevalence and complex diseases of the heart: ERN GUARD-Heart" ( http://guardheart.ern-net.eu)
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Verheul LM, van der Ree MH, Groeneveld SA, Mulder BA, Christiaans I, Kapel GFL, Alings M, Bootsma M, Barge-Schaapveld DQCM, Balt JC, Yap SC, Krapels IPC, Ter Bekke RMA, Volders PGA, van der Crabben SN, Postema PG, Wilde AAM, Dooijes D, Baas AF, Hassink RJ. The genetic basis of apparently idiopathic ventricular fibrillation: a retrospective overview. Europace 2023; 25:euad336. [PMID: 37967257 PMCID: PMC10665040 DOI: 10.1093/europace/euad336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/03/2023] [Indexed: 11/17/2023] Open
Abstract
AIMS During the diagnostic work-up of patients with idiopathic ventricular fibrillation (VF), next-generation sequencing panels can be considered to identify genotypes associated with arrhythmias. However, consensus for gene panel testing is still lacking, and variants of uncertain significance (VUS) are often identified. The aim of this study was to evaluate genetic testing and its results in idiopathic VF patients. METHODS AND RESULTS We investigated 419 patients with available medical records from the Dutch Idiopathic VF Registry. Genetic testing was performed in 379 (91%) patients [median age at event 39 years (27-51), 60% male]. Single-gene testing was performed in 87 patients (23%) and was initiated more often in patients with idiopathic VF before 2010. Panel testing was performed in 292 patients (77%). The majority of causal (likely) pathogenic variants (LP/P, n = 56, 15%) entailed the DPP6 risk haplotype (n = 39, 70%). Moreover, 10 LP/P variants were found in cardiomyopathy genes (FLNC, MYL2, MYH7, PLN (two), TTN (four), RBM20), and 7 LP/P variants were identified in genes associated with cardiac arrhythmias (KCNQ1, SCN5A (2), RYR2 (four)). For eight patients (2%), identification of an LP/P variant resulted in a change of diagnosis. In 113 patients (30%), a VUS was identified. Broad panel testing resulted in a higher incidence of VUS in comparison to single-gene testing (38% vs. 3%, P < 0.001). CONCLUSION Almost all patients from the registry underwent, albeit not broad, genetic testing. The genetic yield of causal LP/P variants in idiopathic VF patients is 5%, increasing to 15% when including DPP6. In specific cases, the LP/P variant is the underlying diagnosis. A gene panel specifically for idiopathic VF patients is proposed.
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Affiliation(s)
- Lisa M Verheul
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3584 CX, The Netherlands
| | - Martijn H van der Ree
- Department of Cardiology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Heart Failure and Arrhythmias, Amsterdam, Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Sanne A Groeneveld
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3584 CX, The Netherlands
| | - Bart A Mulder
- Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Imke Christiaans
- Department of Human Genetics, University Medical Center Groningen, Groningen, The Netherlands
| | - Gijs F L Kapel
- Department of Cardiology, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Marco Alings
- Department of Cardiology, Amphia Hospital, Breda, The Netherlands
| | - Marianne Bootsma
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Jippe C Balt
- Department of Cardiology, St.Antonius Hospital, Nieuwegein, The Netherlands
| | - Sing-Chien Yap
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - Ingrid P C Krapels
- Department of Human Genetics, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Rachel M A Ter Bekke
- Department of Cardiology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Paul G A Volders
- Department of Cardiology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Saskia N van der Crabben
- Department of Human Genetics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Pieter G Postema
- Department of Cardiology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Heart Failure and Arrhythmias, Amsterdam, Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Arthur A M Wilde
- Department of Cardiology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Heart Failure and Arrhythmias, Amsterdam, Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Dennis Dooijes
- Department of Human Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Annette F Baas
- Department of Human Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Rutger J Hassink
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3584 CX, The Netherlands
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Bergeman AT, Hoeksema WF, van der Ree MH, Boersma LVA, Yap SC, Verheul LM, Hassink RJ, van der Crabben SN, Volders PGA, van der Werf C, Wilde AAM, Postema PG. Outcomes in Dutch DPP6 risk haplotype for familial idiopathic ventricular fibrillation: a focused update. Neth Heart J 2023:10.1007/s12471-023-01792-1. [PMID: 37498467 PMCID: PMC10400734 DOI: 10.1007/s12471-023-01792-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND The genetic risk haplotype DPP6 has been linked to familial idiopathic ventricular fibrillation (IVF), but the associated long-term outcomes are unknown. METHODS DPP6 risk haplotype-positive family members (DPP6 cases) and their risk haplotype-negative relatives (DPP6 controls) were included. Clinical follow-up data were collected through March 2023. Implantable cardioverter-defibrillator (ICD) indication was divided in primary or secondary prevention. Cumulative survival and event rates were calculated. RESULTS We included 327 DPP6 cases and 315 DPP6 controls. Median follow-up time was 9 years (interquartile range: 4-12). Of the DPP6 cases, 129 (39%) reached the composite endpoint of appropriate ICD shock, sudden cardiac arrest or death, at a median age of 45 years (range: 15-97). Median overall survival was 83 years and 87 years for DPP6 cases and DPP6 controls, respectively (p < 0.001). In DPP6 cases, median overall survival was shorter for males (74 years) than females (85 years) (p < 0.001). Of the DPP6 cases, 97 (30%) died, at a median age of 50 years. With a prophylactic ICD implantation advise based on risk haplotype, sex and age, 137 (42%) of DPP6 cases received an ICD, for primary prevention (n = 109) or secondary prevention (n = 28). In the primary prevention subgroup, 10 patients experienced a total of 34 appropriate ICD shocks, and there were no deaths during follow-up. DPP6 cases with a secondary prevention ICD experienced a total of 231 appropriate ICD shocks. CONCLUSION Patients with the DPP6 risk haplotype, particularly males, are at an increased risk of IVF and sudden cardiac death. Using a risk stratification approach based on risk haplotype, sex and age, a substantial proportion of patients with a primary prevention ICD experienced appropriate ICD shocks, showing the benefit of prophylactic ICD implantation with this strategy.
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Affiliation(s)
- Auke T Bergeman
- Department of Cardiology, Amsterdam University Medical Centres, location Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Wiert F Hoeksema
- Department of Cardiology, Amsterdam University Medical Centres, location Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Martijn H van der Ree
- Department of Cardiology, Amsterdam University Medical Centres, location Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Lucas V A Boersma
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Sing-Chien Yap
- Department of Cardiology, Erasmus University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Lisa M Verheul
- Department of Cardiology, Division Heart & Lungs, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Rutger J Hassink
- Department of Cardiology, Division Heart & Lungs, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Saskia N van der Crabben
- Department of Human Genetics, Amsterdam University Medical Centres, location Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Paul G A Volders
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Christian van der Werf
- Department of Cardiology, Amsterdam University Medical Centres, location Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Arthur A M Wilde
- Department of Cardiology, Amsterdam University Medical Centres, location Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Pieter G Postema
- Department of Cardiology, Amsterdam University Medical Centres, location Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands.
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Verheul LM, Groeneveld SA, Tuinenburg AE, Hassink RJ. Atrial fibrillation begets ventricular fibrillation when the AV node fails. J Electrocardiol 2023; 76:66-70. [PMID: 36442389 DOI: 10.1016/j.jelectrocard.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022]
Abstract
Deterioration of atrial fibrillation into ventricular fibrillation has frequently been described in patients with pre-excitation of the ventricles. We report two cases of atrial fibrillation without pre-excitation leading to rapid ventricular tachycardias and recurrent implantable cardioverter defibrillator therapy in young idiopathic ventricular fibrillation patients.
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Affiliation(s)
- Lisa M Verheul
- Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Sanne A Groeneveld
- Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Anton E Tuinenburg
- Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Rutger J Hassink
- Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
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7
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Verheul LM, Hardeman HA. [A woman with shortness of breath and a rash]. Ned Tijdschr Geneeskd 2021; 165:D6202. [PMID: 34854630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A 74-year-old woman presented with progressive dyspnoea which started a few days after developing a unilateral dermatomal rash characteristic for herpes zoster at dermatome C4-C5. X-ray of the thorax showed an elevated hemidiaphragm ipsilateral of the skin abnormalities. Cervical herpes zoster is a rare cause of a unilateral elevated hemidiaphragm.
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Affiliation(s)
- Lisa M Verheul
- St. Antonius Ziekenhuis, afd. Longgeneeskunde, Utrecht
- Contact: Lisa M. Verheul
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