Open AccessSilent Myocardial Ischemia and Late Ventricular Repolarization in the Genesis of Ventricular Fibrillation in Humans
Author(s) -
Santinelli Vincenzo,
Modano Pasqualina,
Ferraiuolo Maria,
Santo Daniela,
Oppo Igino,
Fornaro Pasquale,
Chiariello Massimo
Publication year - 1999
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/j.1542-474x.1999.tb00066.x
Subject(s) - medicine , cardiology , ventricular fibrillation , asymptomatic , asystole , coronary artery disease , repolarization , ischemia , ambulatory ecg , j wave , atrial fibrillation , ventricular tachycardia , electrocardiography , electrophysiology
Background We report a well‐documented case of a patient, a 62‐year‐old man, with severe and asymptomatic left main coronary artery disease who had several episodes of silent myocardial ischemia and a syncopal attack during Holter recording. Methods and Results Ambulatory monitoring showed isolated giant U waves separated from the T wave 60 minutes before syncope that was due to reversible ventricular fibrillation lasting about 4 minutes and spontaneously reverting to asystole (7 seconds) and then to atrial fibrillation Conclusion Our experience suggests that myocardial ischemia may differently affect the repolarization times within the myocardium leading to widely disparate repolarization gradients that may represent the arrhythmogenic substrate for the occurrence of life‐threatening ventricular tachyarrhythmias. A.N.E. 1999; 4(2):250–254