Idiopathic ventricular fibrillation in out-of-hospital cardiac arrest survivors

R. T. Tung, W. K. Shen, S. C. Hammill, B. J. Gersh

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

This study examined diagnostic and therapeutic roles of electrophysiological testing and long-term clinical outcome after out-of- hospital cardiac arrest due to idiopathic ventricular fibrillation. This is defined as ventricular fibrillation occurring in the absence of detectable underlying heart disease or metabolic or electrolyte disturbance. Out-of- hospital cardiac arrest resulting from idiopathic ventricular fibrillation is uncommon. Records of all patients who underwent electrophysiological testing between June 1979 and June 1992 were reviewed. Patients with out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation were identified. Follow-up information was obtained by telephone interview in June 1992. Of 194 patients who underwent electrophysiological study after out-of-hospital cardiac arrest not associated with acute myocardial infarction, only six (4 male and 2 female) had idiopathic ventricular fibrillation. It was induced in only two patients by programmed ventricular stimulation. No sustained ventricular arrhythmias were induced in the remaining four patients. Four patients received implantable cardioverter defibrillators, one was treated with a β-adrenergic blocker, and one received no treatment. All patients were alive at a mean follow-up of 50 months. Two of the four patients without inducible sustained ventricular arrhythmias had events during follow-up. Of the two patients with inducible ventricular fibrillation, one experienced a cardiac arrest and documented ventricular fibrillation at 41 months after the index event and the other had had no recurrence at 15-month follow-up. All four patients with implantable cardioverter defibrillators were alive at last follow-up, and two had device discharges. In survivors of out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation: (1) programmed electrical stimulation is of limited value for evaluating cause and guiding therapy; (2) a high rate of recurrent events is observed (50%); and (3) an implantable cardioveter defibrillator is effective for preventing a fatal outcome.

Original languageEnglish (US)
Pages (from-to)1405-1412
Number of pages8
JournalPACE - Pacing and Clinical Electrophysiology
Volume17
Issue number8
DOIs
StatePublished - 1994

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Out-of-Hospital Cardiac Arrest
Survivors
Implantable Defibrillators
Ventricular Fibrillation
Cardiac Arrhythmias
Paroxysmal ventricular fibrillation
Adrenergic Antagonists
Fatal Outcome
Heart Arrest
Electrolytes
Electric Stimulation
Heart Diseases
Therapeutics
Myocardial Infarction
Interviews

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Idiopathic ventricular fibrillation in out-of-hospital cardiac arrest survivors. / Tung, R. T.; Shen, W. K.; Hammill, S. C.; Gersh, B. J.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 17, No. 8, 1994, p. 1405-1412.

Research output: Contribution to journalArticle

Tung, R. T. ; Shen, W. K. ; Hammill, S. C. ; Gersh, B. J. / Idiopathic ventricular fibrillation in out-of-hospital cardiac arrest survivors. In: PACE - Pacing and Clinical Electrophysiology. 1994 ; Vol. 17, No. 8. pp. 1405-1412.
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