[Sudden death during continous electrocardiographic recording by Holter's method]

Area of Science:

• Cardiology
• Clinical Electrophysiology

Background:

• A 79-year-old male with a history of respiratory insufficiency, myocardial infarction, and hemiplegia underwent Holter monitoring.
• Sudden cardiac death occurred at home following defecation.

Observation:

• Continuous electrocardiographic recording revealed multiple polymorphic ventricular extrasystoles, frequently in doublets.
• The fatal event was preceded by a salvo of three ventricular extrasystoles.

Findings:

• The extrasystoles triggered ventricular tachycardia, which rapidly progressed to ventricular fibrillation.
• The arrhythmia may have been precipitated by adrenergic stimulation from defecation or acute myocardial infarction.

Implications:

• This case highlights the utility of Holter monitoring in evaluating arrhythmia severity.
• The absence of an R on T phenomenon before the terminal event is noteworthy.