An unusual cause of ventricular fibrillatory arrest

2020 ◽  
Vol 30 (8) ◽  
pp. 1178-1182
Author(s):  
Utkarsh Kohli ◽  
Elizabeth Meinert
Keyword(s):  
Ventricular Arrhythmias ◽  
Sudden Cardiac Arrest ◽  
Viral Myocarditis ◽  
Cardiac Biomarkers ◽  
Mri Findings ◽  
Cardioverter Defibrillator ◽  
Long Run ◽  
Echocardiographic Findings ◽  
Wearable Defibrillator

AbstractMyocarditis is an important cause of arrhythmogenic sudden cardiac arrest in the young. A strong index of suspicion is required as not only can arrhythmias be the only clinical manifestation but also because these patients can have normal cardiac biomarkers, electrocardiographic and echocardiographic findings, and inflammatory markers. Patients with ventricular arrhythmias in the setting of viral myocarditis, especially the ones in whom cardiac MRI findings normalise upon follow-up, tend to do well in the long run and an implantable cardioverter-defibrillator should be avoided in these patients; instead, a wearable defibrillator should be temporarily used as we did in this 7-year-old.

1175Structural progression increases the risk of ventricular arrhythmias in patients with arrhythmogenic cardiomyopathy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Chivulescu ◽  
Ø.H Lie ◽  
H Skulstad ◽  
B A Popescu ◽  
R O Jurcut ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Ventricular Arrhythmias ◽  
Arrhythmogenic Cardiomyopathy ◽  
Cardioverter Defibrillator ◽  
Structural Progression ◽  
Life Threatening ◽  
Arrhythmic Event ◽  
History Of ◽  
Structural Disease

Abstract Background Arrhythmogenic cardiomyopathy (AC) is an inheritable cardiomyopathy with incomplete penetrance, variable phenotype severity and poorly described disease progression. It is characterized by high risk of life-threatening ventricular arrhythmias and sudden cardiac death in young individuals. Risk stratification and selection of patients presenting without history of life-threatening arrhythmic events for cardioverter-defibrillator implantation in primary prevention remains challenging. Purpose We aimed to assess the impact of disease progression on arrhythmic outcomes in AC patients. Methods We included consecutive AC probands and mutation-positive family members with at least one complete follow-up evaluation. Echocardiographic and electrical parameters were defined according to the 2010 Revised Task Force criteria at inclusion and at last follow-up. Structural progression was defined as development of new echocardiographic diagnostic criteria. Electrical progression was defined as the development of new diagnostic depolarization, repolarization and/or premature ventricular complex count criteria during follow-up. Non-sustained ventricular tachycardia or ventricular tachycardia occurring during follow-up defined incident ventricular arrhythmic events. Results We included a total of 144 patients (48% female, 47% probands, 40±16 years old). At inclusion, 54 patients (37%) had a history of arrhythmic events, 30 patients (21%) had overt structural disease and 114 (79%) had no or minor structural disease. During 7.0 (IQR: 4.5 to 9.4) years of follow-up, 49 patients (43%) with no or minor structural disease at inclusion developed new structural criteria being defined as progressors. Among 80 participants with no or minor structural disease and no arrhythmic history at inclusion, a first arrhythmic event occurred in 14 (17%). The incidence of arrhythmic events was higher in progressors (11/27, 41%) than in non-progressors (3/53, 6%) (p<0.001) (Figure). Structural progression was associated with higher risk of first arrhythmic events during follow-up when adjusted for sex, age at inclusion and follow-up duration, independent of electrical progression (7.6, 95% CI [1.5, 37.2], P=0.01). Incident arrhythmic events distribution Conclusion Almost half of patients without overt structural cardiac disease at genetic diagnosis develop new structural criteria during 7 years follow-up and 17% experienced their first ventricular arrhythmic event. Structural progression was independently associated with ventricular arrhythmic events during follow-up. These findings highlight the increased risk of arrhythmias when structural abnormalities are detected. Their finding may initiate the evaluation for primary prevention cardioverter-defibrillator implantation.

Calcifying myocarditis mimicking an intracardiac tumor on fetal echocardiography

1993 ◽  
Vol 3 (2) ◽  
pp. 158-160 ◽  
Author(s):  
Renate Oberhoffer ◽  
Uwe Hillen ◽  
Dieter Lang
Keyword(s):  
Fetal Echocardiography ◽  
Viral Myocarditis ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Left Ventricular Myocardium ◽  
Intracardiac Mass ◽  
Intracardiac Tumor ◽  
Histological Results ◽  
Echocardiographic Findings

SummaryWe report echocardiographic findings of an intracardiac mass in a hydropic fetus who died after four weeks of follow-up. Within that period, the left ventricular myocardium had developed extensive echo-dense patterns suggesting tumorous infiltration. Autopsy revealed extreme calcification of the mitral valve, which had mimicked a tumorous mass on fetal echocardiography. The histological results were consistent with viral myocarditis.

scholarly journals Undetected displacement of a subcutaneous implantable cardioverter-defibrillator lead. importance of performing a chest X-ray during the first weeks post-implant: a case report

2019 ◽  
Author(s):  
Jose Apolo ◽  
Rodolfo San Antonio ◽  
Lluís Mont ◽  
José María Tolosana
Keyword(s):  
Implantable Cardioverter Defibrillator ◽  
Ventricular Arrhythmias ◽  
Xiphoid Process ◽  
Icd Implantation ◽  
X Ray ◽  
Cardioverter Defibrillator ◽  
Case Summary ◽  
Chest X Ray ◽  
Defibrillator Lead

Abstract Background In recent years, subcutaneous implantable cardioverter-defibrillator (S-ICD) implants have progressively increased and have been shown to be safe and highly successful, affording low reintervention rates regardless of the technique used. Case summary We present a case of S-ICD implantation in a patient diagnosed with idiopathic ventricular fibrillation. In the first follow-up consultation the patient showed appropriate detection parameters in the three configurations. However, chest X-ray revealed lead displacement with a tip migration from the manubrium area of the sternum to the xiphoid process. Discussion This case highlights the importance of performing at least one chest X-ray during the first weeks after S-ICD implantation, allowing the detection of a problem such as lead displacement, which can lead to undersensing of ventricular arrhythmias or S-ICD oversensing.

scholarly journals Strategies to Reduce Recurrent Shocks Due to Ventricular Arrhythmias in Patients with an Implanted Cardioverter-Defibrillator

2019 ◽  
Vol 8 (2) ◽  
pp. 99-104 ◽  
Author(s):  
Steven H Back ◽  
Peter R Kowey
Keyword(s):  
Quality Of Life ◽  
Ventricular Arrhythmias ◽  
Sudden Cardiac Arrest ◽  
Mortality Rates ◽  
Poor Quality ◽  
Cardioverter Defibrillator ◽  
Patient Morbidity ◽  
Life Saving ◽  
Icd Shock

Ventricular arrhythmias are a therapeutic challenge, owing to their relatively unpredictable and deadly nature. Many patients are treated with an implantable cardioverter-defibrillator for either primary or secondary prevention of ventricular arrhythmias, meaning those who are at high risk of versus those who have experienced ventricular arrhythmias or sudden cardiac arrest, respectively. Despite the life-saving benefit, ICD comes with the risk of recurrent shocks for both appropriate and inappropriate rhythms. Patients with recurrent shocks have a poor quality of life and increased mortality rates. In this article, we review data for optimal device settings, medical management and radiofrequency ablation strategies to minimise the frequency of ICD shock, with a focus on treatment of ventricular arrhythmias, to reduce patient morbidity and mortality, and to maximise wellbeing and quality of life.

Sign in / Sign up

Export Citation Format

Share Document