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Atrial fibrillation begets ventricular fibrillation when the AV node fails
Lisa M Verheul1, Sanne A Groeneveld1, Anton E Tuinenburg1
1Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands.
Journal of Electrocardiology
|November 28, 2022
Summary
Atrial fibrillation can cause rapid ventricular tachycardia even without pre-excitation. This can lead to recurrent implantable cardioverter defibrillator therapy in young patients with idiopathic ventricular fibrillation.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Case Reports
Background:
- Atrial fibrillation progressing to ventricular fibrillation is often associated with ventricular pre-excitation.
- Idiopathic ventricular fibrillation (IVF) is a rare condition primarily affecting young individuals.
Purpose of the Study:
- To report two cases of atrial fibrillation without pre-excitation leading to rapid ventricular tachycardias.
- To highlight a previously under-described pathway to life-threatening ventricular arrhythmias in young IVF patients.
Main Methods:
- Case report analysis of two young patients with idiopathic ventricular fibrillation.
- Review of electrophysiological findings and clinical outcomes.
Main Results:
- Both patients experienced atrial fibrillation that degenerated into rapid ventricular tachycardias.
- Neither patient had evidence of ventricular pre-excitation.
- Both patients required recurrent implantable cardioverter defibrillator (ICD) therapy.
Conclusions:
- Atrial fibrillation can precipitate ventricular tachycardias in young patients with IVF, even in the absence of pre-excitation.
- This finding expands the understanding of arrhythmia mechanisms in IVF.
- Clinicians should consider atrial fibrillation as a potential trigger for ventricular arrhythmias in this population.
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