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Postpausal ventricular fibrillation analyzed by Holter-ECG: a case report
Pacing and Clinical Electrophysiology : PACE
|December 1, 1992
Summary
A patient experienced cardiac arrest due to ventricular fibrillation during urination. Holter monitoring revealed specific heart rhythm changes preceding the event, including ventricular premature beats.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
Background:
- A 70-year-old male with a history of myocardial infarction experienced sudden cardiac arrest.
- The event occurred coincidentally during Holter monitoring while the patient was urinating.
Observation:
- The patient presented with ventricular fibrillation (VF) and was successfully resuscitated via defibrillation.
- Holter tape analysis identified atrial fibrillation and secondary ventricular premature beats (VPBs).
- These VPBs were characterized by their dependence on a preceding long R-R interval.
Findings:
- The ventricular fibrillation was immediately preceded by an unusually long R-R interval (1.45 seconds).
- This long interval followed a series of short R-R intervals, indicating a rapid deceleration in ventricular rate.
- A significant alteration in T wave morphology was observed just before the onset of VF.
Implications:
- This case highlights a potential trigger for cardiac arrest in patients with cardiovascular disease.
- The findings underscore the importance of Holter monitoring in identifying specific arrhythmias and preceding electrocardiographic changes.
- Understanding the relationship between micturition, heart rate variability, and VF can inform clinical management and preventative strategies.