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Primary ventricular fibrillation. Some unusual features

D S Sheps, C A Conde, A Mayorga-Cortes

    Chest
    |August 1, 1977
    PubMed
    Summary
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    This study reports a rare case of recurrent ventricular fibrillation in a patient with normal cardiac function. Unusual features like auditory auras and abnormal oxygen transport were noted, suggesting potential links to cardiac arrhythmias.

    Area of Science:

    • Cardiology
    • Electrophysiology
    • Internal Medicine

    Background:

    • Recurrent ventricular fibrillation (VF) is a life-threatening cardiac arrhythmia.
    • Identifying the underlying causes of VF is crucial for effective management.
    • Idiopathic VF, where no structural or electrical abnormality is found, presents diagnostic challenges.

    Observation:

    • A 47-year-old male experienced three episodes of ventricular fibrillation over 3.5 years.
    • Each VF episode was preceded by a distinct auditory aura.
    • No ventricular irritability was detected between the episodes.
    • Comprehensive cardiac evaluations, including coronary arteriography, hemodynamic assessments, and intracardiac electrophysiologic studies, yielded normal results.

    Findings:

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  • The patient presented with hypokalemia (low potassium levels).
  • Abnormal oxyhemoglobin dissociation, affecting oxygen release to tissues, was also identified.
  • These findings were present in the absence of identifiable structural heart disease or primary electrical abnormalities.

    • Implications:

    • This case highlights the importance of considering non-cardiac factors in unexplained arrhythmias.
    • Auditory auras as a prodrome to VF are highly unusual and warrant further investigation.
    • Hypokalemia and altered oxygen transport may play a role in triggering VF in susceptible individuals.
    • Further research is needed to elucidate the relationship between these unusual features and cardiac rhythm disturbances.