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Idiopathic left ventricular aneurysm and sudden cardiac death in young adults

Matthias Paul1, Michael Schäfers, Matthias Grude

  • 1Department of Cardiology and Angiology, University Hospital of Münster, Albert-Schweitzer-Str. 33, D-48149 Münster, Germany. mapaul@uni-muenster.de

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
|July 26, 2006
PubMed

Insights

Idiopathic left ventricular aneurysms can cause life-threatening arrhythmias like ventricular tachycardia/fibrillation in young patients. Advanced imaging and radionuclide studies aid diagnosis and understanding of autonomic nervous system involvement.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Medical Imaging

Background:

  • Young patients presenting with sudden cardiac arrest or life-threatening ventricular arrhythmias require thorough diagnostic evaluation.
  • Idiopathic left ventricular aneurysms are a rare but critical cause of such cardiac events.

Observation:

  • Three young patients experienced life-threatening ventricular tachycardia (VT) or ventricular fibrillation (VF).
  • Idiopathic left ventricular aneurysms were diagnosed using comprehensive non-invasive and invasive evaluations, including echocardiography, MRI, and LV angiography.
  • Programmed ventricular stimulation induced sustained VT/VF in two patients.

Findings:

  • Myocardial viability and sympathetic innervation were assessed using radionuclide imaging.
  • Defects in innervation and metabolism were localized to the aneurysm area.
  • No downstream denervation was observed distal to the aneurysm.

Implications:

  • Idiopathic left ventricular aneurysms can manifest initially as severe arrhythmias.
  • Modern imaging techniques reliably diagnose these aneurysms.
  • Radionuclide imaging provides insights into autonomic nervous system involvement in arrhythmogenesis.
  • Management options include antiarrhythmic drugs, cardioverter-defibrillator implantation, or surgical aneurysmectomy.
Abstract

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