Ventricular fibrillation induced by transesophageal atrial pacing in hypertrophic cardiomyopathy.
Sudden death is a rather frequent occurrence in patients with hypertrophic cardiomyopathy, yet the mechanism is uncertain in most cases. We describe a case of an 18 years old patient with a family history of hypertrophic cardiomyopathy and sudden death in whom ventricular fibrillation could be repeatedly induced by means of transesophageal atrial stimulation with 1:1 AV conduction at a rate of 200 beats min-1 and prevented by pharmacological depression of AV node. The not particularly high ventricular rate at which VF occurred could suggest that in hypertrophic cardiomyopathy a major role in favouring VF induction is played by the electrophysiological properties of the myocardium and that sudden death can occur as a consequence of different atrial tachyarrhythmias.
Favale
S
S
Division of Cardiology, University of Bari, Italy.
Di Biase
M
M
Rizzo
U
U
Minafra
F
F
Rizzon
P
P
D000293:Adolescent; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects*; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000235:genetics / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria; D006801:Humans; D014693:Ventricular Fibrillation / Q000209:etiology* / Q000503:physiopathology