2.Arrhythmogenic right ventricular cardiomyopathy associated with arrhythmia-induced cardiomyopathy: A case report.
Shao Min CHEN ; Chao SUN ; Xin Yu WANG ; Yuan ZHANG ; Shu Wang LIU
Journal of Peking University(Health Sciences) 2021;53(5):1002-1006
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a kind of inherited cardio-myopathy, which is characterized by fibro-fatty replacement of right ventricular myocardium, leading to ventricular arrhythmia. However, rapid atrial arrhythmias are also common, including atrial fibrillation, atrial flutter and atrial tachycardia. Long term rapid atrial arrhythmia can lead to further deterioration of cardiac function. This case is a 51-year-old male. He was admitted to Department of Cardiology, Peking University Third Hospital with palpitation and fatigue after exercise. Electrocardiogram showed incessant atrial tachycardia. Echocardiography revealed dilation of all his four chambers, especially the right ventricle, with the left ventricular ejection fraction of 40% and the right ventricular hypokinesis. Cardiac magnetic resonance imaging found that the right ventricle was significantly enlarged, and the right ventricular aneurysm had formed; the right ventricular ejection fraction was as low as 8%, and the left ventricular ejection fraction was 35%. The patients met the diagnostic criteria of ARVC, and both left and right ventricles were involved. His physical activities were restricted, and metoprolol, digoxin, spironolactone and ramipril were given. Rivaroxaban was also given because atrial tachycardia could cause left atrial thrombosis and embolism. His atrial tachycardia converted spontaneously to normal sinus rhythm after these treatments. Since the patient had severe right ventricular dysfunction, frequent premature ventricular beats and non-sustained ventricular tachycardia on Holter monitoring, indicating a high risk of sudden death, implantable cardioverter defibrillator (ICD) was implanted. After discharge from hospital, physical activity restriction and the above medicines were continued. As rapid atrial arrhythmia could lead to inappropriate ICD shocks, amiodarone was added to prevent the recurrence of atrial tachycardia, and also control ventricular arrhythmia. After 6 months, echocardiography was repeated and showed that the left ventricle diameter was reduced significantly, and the left ventricular ejection fraction increased to 60%, while the size of right ventricle and right atrium decreased slightly. According to the clinical manifestations and outcomes, he was diagnosed with ARVC associated with arrhythmia induced cardiomyopathy. According to the results of his cardiac magnetic resonance imaging, the patient had left ventricular involvement caused by ARVC, and the persistent atrial tachycardia led to left ventricular systolic dysfunction.
Arrhythmogenic Right Ventricular Dysplasia/complications*
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Atrial Fibrillation
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Humans
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Male
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Middle Aged
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Stroke Volume
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Ventricular Function, Left
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Ventricular Function, Right
4.Fever-Induced QTc Prolongation and Ventricular Fibrillation in a Healthy Young Man.
Sun Min LIM ; Hui Nam PAK ; Moon Hyoung LEE ; Sung Soon KIM ; Boyoung JOUNG
Yonsei Medical Journal 2011;52(6):1025-1027
Long QT syndrome is associated with lethal tachyarrhythmia that can lead to syncope, seizure, and sudden death. Congenital long QT syndrome is a genetic disorder, characterized by delayed cardiac repolarization and prolongation of the QT interval on the electrocardiogram (ECG). Type 2 congenital long QT is linked to mutations in the human ether a go-go-related gene (HERG). There are environmental triggers of adverse cardiac events such as emotional and acoustic stimuli, but fever can also be a potential trigger of life-threatening arrhythmias in long QT syndrome type 2 patients. Herein, we report a healthy young man who experienced fever-induced polymorphic ventricular tachycardia and QT interval prolongation.
Adult
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Electrocardiography
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Fever/*complications
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Humans
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Long QT Syndrome/*diagnosis/*etiology
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Male
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Ventricular Fibrillation/*diagnosis/*etiology
6.Propofol terminates ventricular fibrillation storm caused by pulmonary embolism.
Jiang HONG ; Mengdan XU ; Ailing KONG ; Qiang LIU ; Rong CHEN ; Qiuyan DAI ; Lexin WANG ; Baogui SUN
Chinese Medical Journal 2014;127(21):3840-3840
9.Time distribution of ventricular arrhythmias in patients with Brugada syndrome.
Bing YANG ; Ke-jiang CAO ; Qi-jun SHAN ; Yun XIA ; Jing TU ; Ming-long CHEN ; Jian-gang ZOU ; Dong-jie XU ; Ku-lin LI ; Chun CHEN
Chinese Journal of Cardiology 2006;34(5):429-432
OBJECTIVETo study the characterization of time distribution of ventricular arrhythmias in patients with Brugada syndrome (BrS) using Holter monitoring and ICD follow-up.
METHODSPatients with BrS [all male, mean age (41.07 +/- 11.49) years], were divided into ventricular fibrillation (VF) group (n = 7) and no ventricular fibrillation (N-VF) group (n = 7). Premature ventricular capture (PVC) and VF episodes were detected by Holter monitoring and ICD recording.
RESULTSThe 24 hours total number of PVCs ranged from 0 to 74 (mean 9.61 +/- 17.23) in most of the patients and were similar between VF group and N-VF group. The percentage of PVC episodes in VF group was significantly higher than that in N-VF group from nocturnal time to early morning (22:00 to 7:00, 98.67% vs. 44.14%, P < 0.01). There were total 75 VF episodes during (23.18 +/- 17.96) months' follow-up in 5 patients with BrS, 93.3% of which occurred from nocturnal time to early morning (22:00 to 7:00).
CONCLUSIONSThe episodes of PVC were enriched from nocturnal time to early morning in BrS patients, this time distribution could be a new noninvasive risk stratification factor for BrS. The episodes of VF in BrS patients were also enriched from nocturnal time to early morning and this time characteristic of episodes of VF could be used to guide drug therapy.
Adult ; Brugada Syndrome ; complications ; physiopathology ; Electrocardiography ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Risk Factors ; Time ; Ventricular Fibrillation ; etiology
10.A simulation study of the effects of ischemia on spiral waves in 2D human ventricular tissue.
Yongfeng YUAN ; Kuanquan WANG ; Huili TIAN
Journal of Biomedical Engineering 2009;26(6):1329-1334
Based on human ventricular single cell mathematical model, a two-dimensional mesh of ventricular wall tissue was constructed. Through the increasing of the concentration of extracellular K+, we simulated the propagation of spiral wave in a condition under the influence of ischemia in 2-D human ventricular tissue. The results showed that along with the increase of ischemic level and size, the instability of spiral waves increased, and under the influence of certain ischemic level and size, spiral waves broke up. Through this simulation study of the effects of ischemia on spiral waves in 2-D human ventricular tissue, we explained the corresponding mechanism of the maintenance of ventricular tachycardia and the cause of ventricular fibrillation under the influence of ischemia.
Arrhythmias, Cardiac
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etiology
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physiopathology
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Computer Simulation
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Heart Ventricles
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Humans
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Models, Cardiovascular
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Myocardial Ischemia
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complications
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physiopathology
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Tachycardia, Ventricular
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etiology
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physiopathology
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Ventricular Fibrillation
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etiology
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physiopathology