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Related Experiment Videos

Ventricular arrhythmia with postural dependency.

T Shibuya, M Kimura, E Oda

    Journal of Electrocardiology
    |July 1, 1985
    PubMed
    Summary

    This study found that postural ventricular arrhythmias in a young man with myocarditis were linked to a slow heart rate and vagal nerve activity. These arrhythmias were controlled by tilting the body or using atropine.

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    Area of Science:

    • Cardiology
    • Electrophysiology
    • Internal Medicine

    Background:

    • Idiopathic myocarditis can present with complex cardiac arrhythmias.
    • Refractory ventricular arrhythmias pose a significant clinical challenge.

    Observation:

    • A 17-year-old male with mild idiopathic myocarditis experienced ventricular arrhythmias specifically related to body position.
    • Arrhythmias occurred in supine and slightly tilted positions but resolved with greater than 30-degree tilt.
    • Arrhythmias worsened with decreased sinus rate (sleep, recumbency) and improved with exercise or atropine.

    Findings:

    • Postural ventricular arrhythmias were reproducibly observed and linked to relative bradycardia.
    • Arrhythmias were abolished by atropine and suppressed by atrial pacing, indicating a vagal component.

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  • Standard electrophysiological testing, including programmed ventricular stimulation, did not induce ventricular tachycardia.

    • Implications:

    • Enhanced vagal nerve activity may trigger ventricular arrhythmias in susceptible individuals.
    • Positional changes and autonomic modulation can influence arrhythmia occurrence.
    • Understanding the role of the autonomic nervous system is crucial for managing certain cardiac arrhythmias.