Ventricular fibrillation in a patient with Wolff‐Parkinson‐White syndrome unrelated to pre‐excited atrial fibrillation. Issue 6 (29th May 2019)

• Record Type: Journal Article
• Authors: Aranyo, Julia; Bazan, Victor; Rueda, Ferran; Sarrias, Axel; Bisbal, Felipe; Villuendas, Roger
• Is Part Of: Annals of noninvasive electrocardiology. Volume 24:Issue 6(2019:Nov.)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-05-29
• Subjects: AV reentry/WPW -- basic -- cardiac arrest/sudden death -- clinical electrophysiology -- ventricular tachycardia/fibrillation; Electrocardiography -- Periodicals; Arrhythmia -- Periodicals; 616.1207547
• DOI: 10.1111/anec.12662
• Languages: English
• ISSNs: 1082-720X

Abstract

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.