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ISSN 2078-7170 (Electronic)

2023, Number 1

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CorSalud 2023; 15 (1)

Idiopathic ventricular fibrillation triggered by short-coupled premature ventricular contractions (short-coupled idiopathic ventricular fibrillation): A New Phenotype? Cuban Experience

Dorantes SM, Ponce PEF, Castañeda CO, Castro HJA, Falcón RR, Martínez LF

Language: Spanish
References: 17
Page: 3-10
PDF size: 635.99 Kb.


ABSTRACT

Introduction: Idiopathic ventricular fibrillation triggered by short-coupled prema-ture ventricular contractions has been studied for years; recently, it has been pro-posed as a new phenotype called short-coupled idiopathic ventricular fibrillation (sc-IVF).
Objective: To describe the clinical and electrocardiographic evolution of patients with sc-IVF.
Method: A descriptive study on patients with sc-IVF was carried out. Patients with other diseases that could cause ventricular fibrillation (such as channelopathies and specific electrical diseases) were excluded. Short-coupled premature ventricular contraction was defined as a coupling interval of less than or equal to 300 ms, lo-cated on the ascending branch or top of the T wave, or on its descending branch, and some cases with “not-so-short” intervals were also considered.
Results: Twelve subjects suffering from sc-IVF, without structural heart disease demonstrated by conventional methods, were studied. The average age was 37.9 years (minimum 15, maximum 60), with 6 patients were female and 6 male patients. The onset in all cases was sudden death due to ventricular fibrillation, and in six patients, torsades de pointes were also associated. The location of the ventricular extrasystole could vary in the same patient; the lowest value was taken, and it pre-vailed in the ascending branch or at the top of the T wave (66.6%, minimum value 220 ms). There were four cases exhibiting “not-so-short” coupling intervals. Two pa-tients died, both without an implantable cardioverter-defibrillator.
Conclusions: Idiopathic ventricular fibrillation triggered by short-coupled prema-ture ventricular contractions constitutes a new phenotype within the spectrum of malignant ventricular arrhythmias. Shorter intervals are associated with higher ma-lignancy. The association with torsades de pointes is frequent.


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