Open AccessVentricular fibrillation in a patient with Wolff‐Parkinson‐White syndrome unrelated to pre‐excited atrial fibrillation
Author(s) -
Aranyo Julia,
Bazan Victor,
Rueda Ferran,
Sarrias Axel,
Bisbal Felipe,
Villuendas Roger
Publication year - 2019
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/anec.12662
Subject(s) - medicine , cardiology , ventricular fibrillation , atrial fibrillation , accessory pathway , repolarization , fibrillation , coronary vasospasm , anesthesia , hypothermia , electrophysiology , myocardial infarction , coronary angiography , catheter ablation
A 52‐year‐old man was admitted due to out‐hospital cardiac arrest. Recurrent ventricular fibrillation (VF) occurred under therapeutic hypothermia thereafter. Previously inadverted full pre‐excitation was documented exclusively and immediately prior to 4 out of the 5 VF relapses. Coronary vasospasm and early repolarization were also documented. An electrophysiological study demonstrated poor anterograde conduction over a left‐sided accessory pathway. We theorize that maximum pre‐excitation favored in‐hospital VF by augmenting the repolarization vulnerability induced by therapeutic hypothermia, with coronary vasospasm accounting as the probable cause of out‐hospital VF. A plausible VF mechanism in WPW syndrome unrelated to pre‐excited atrial fibrillation is discussed.