title: Mode of onset of malignant ventricular arrhythmias in idiopathic ventricular fibrillation.
abstract: BACKGROUND
  The mode of onset of malignant ventricular arrhythmias (ventricular tachycardia [VT] or ventricular fibrillation [VF]) has been well described in patients with organic heart disease and in patients with the long QT syndromes. Less is known about the mode of onset of VF in patients with out-of-hospital VF who have no evidence of organic heart disease or identifiable etiology.
  
  
  RESULTS
  We reviewed the ECGs of all our patients with idiopathic VF. Documentation of the onset of spontaneous arrhythmias was available for 22 VF episodes in 9 patients (6 men and 3 women; age 41 +/- 16 years). In all instances, spontaneous VF followed a rapid polymorphic VT, which was initiated by premature ventricular complexes (PVCs) with very short coupling intervals. The PVC initiating VF had a coupling interval of 302 +/- 52 msec and a prematurity index of 0.4 +/- 0.07. These PVCs occurred within 40 msec of the peak of the preceding T wave. Pause-dependent arrhythmias were never observed.
  
  
  CONCLUSIONS
  Cardiac arrest among patients with idiopathic VF has a very distinctive mode of onset. Documentation of a polymorphic VT that is not pause dependent is of diagnostic value.
authors.affiliation: Department of Cardiology, Sourasky-Tel Aviv Medical Center, Sackler-School of Medicine, Tel Aviv University, Israel. viskin_s@netvision.net.il
authors.forename: S
authors.initials: S
authors.lastname: Viskin
authors.forename: M D
authors.initials: MD
authors.lastname: Lesh
authors.forename: M
authors.initials: M
authors.lastname: Eldar
authors.forename: R
authors.initials: R
authors.lastname: Fish
authors.forename: I
authors.initials: I
authors.lastname: Setbon
authors.forename: S
authors.initials: S
authors.lastname: Laniado
authors.forename: B
authors.initials: B
authors.lastname: Belhassen
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000503:physiopathology*; D014693:Ventricular Fibrillation / Q000503:physiopathology*; D018879:Ventricular Premature Complexes / Q000503:physiopathology