Related Experiment Videos
Postpausal ventricular fibrillation analyzed by Holter-ECG: a case report
Insights
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.
Abstract:
A 70-year-old male patient with a myocardial infarction, 3 months previously, happened to be wearing a Holter monitor at cardiac arrest during micturition. The patient had ventricular fibrillation (VF) and was successfully resuscitated by means of defibrillation. Analysis of the Holter tape revealed atrial fibrillation and secondary ventricular premature beats (VPB), i.e., VPBs dependent upon a relatively long interval between the two preceding heartbeats. The VF was preceded by an especially long R-R interval (1.45 sec) following a run of especially short R-R intervals implying the sharpest deceleration of the ventricular rate during 1 hour Holter recording preceding the cardiac arrest. A peculiar large alteration of the T wave configuration was also found to precede the VF.