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Ventricular fibrillation induced by rapid atrial rates in patients with hypertrophic cardiomyopathy

M López Gil1, F Arribas, F G Cosío

  • 1Servicio de Cardiología, Hospital 12 de Octubre, Carretera de Andalucía, km 5,4, 28041 Madrid, Spain.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|February 24, 2001
PubMed

Insights

Rapid atrial rates can induce ventricular fibrillation (VF) in hypertrophic cardiomyopathy (HCM) patients. Atrioventricular junctional ablation may prevent VF in select cases.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Genetics

Background:

  • Hypertrophic cardiomyopathy (HCM) is a genetic heart muscle disease.
  • Rapid atrial rates are a known trigger for arrhythmias in HCM patients.

Observation:

  • Three HCM patients underwent electrophysiological studies for VF induced by rapid atrial rates.
  • VF was induced by atrial pacing in all patients, with QRS widening preceding fibrillation.
  • Mechanisms included electrophysiological instability and potential ischemic events.

Findings:

  • Rapid atrial rates triggered ventricular fibrillation (VF) in some hypertrophic cardiomyopathy (HCM) patients.
  • Atrioventricular (AV) junctional ablation was effective in preventing VF recurrence in two patients.
  • Pacemaker implantation successfully managed syncope in a patient with post-atrial fibrillation pauses.

Implications:

  • Understanding the mechanisms of VF induction by rapid atrial rates is crucial for HCM management.
  • AV junctional ablation is a potential strategy to prevent VF in selected HCM patients.
  • Further research into the interplay of electrophysiological and ischemic mechanisms is warranted.
Abstract

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