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Case Reports
. 2022 Apr 19;8(7):488-492.
doi: 10.1016/j.hrcr.2022.04.009. eCollection 2022 Jul.

Atrial pacing successfully suppressed drug-resistant ventricular fibrillation in a patient with early repolarization syndrome

Shushi Nishiwaki  1 , Satoshi Shizuta  1 , Munekazu Tanaka  1 , Akihiro Komasa  1 , Hirohiko Kohjitani  1 , Takeshi Kimura  1
Affiliations
Case Reports

Atrial pacing successfully suppressed drug-resistant ventricular fibrillation in a patient with early repolarization syndrome

Shushi Nishiwaki et al. HeartRhythm Case Rep. .
No abstract available

Keywords: Atrial pacing; Early repolarization syndrome; Electrocardiogram; Implantable cardioverter-defibrillator; Ventricular fibrillation.

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Figures

Figure 1
Figure 1
A: Electrocardiogram (ECG) at baseline (first hospitalization) without antiarrhythmic drug use. Distinct J waves were observed at inferior and lateral leads, with an average amplitude of 0.36 ± 0.09 mV. B: ECG at the time of hospital admission for transvenous implantable cardioverter-defibrillator battery exchange (second hospitalization) under quinidine 600 mg/day. The average amplitude of the J waves at inferior and lateral leads was 0.17 ± 0.05 mV, significantly lower than the baseline (P = .002). C: Intracardiac ECG of ventricular fibrillation (VF) preceded by sinus bradycardia on day 2 after battery exchange. The R-R interval just before the onset of VF was 1172 ms.
Figure 2
Figure 2
A: Treatment chart during the entire period, including first and second hospitalizations. B: Treatment chart during second hospitalization. Blue arrows indicate ventricular fibrillation attacks with spontaneous termination and red arrows indicate those with implantable cardioverter-defibrillator shocks. AF = atrial fibrillation; ICD = implantable cardioverter-defibrillator; VF = ventricular fibrillation.
Figure 3
Figure 3
A: Changes of electrocardiograms at inferior and lateral leads at various heart rates. The J-wave amplitudes were markedly decreased by high-rate atrial pacing. B: Plots of the J-wave amplitudes at the inferior and lateral leads at various heart rates. The amplitudes of the J waves decreased according to heart rates, almost reaching a plateau at 75 beats/min. Abbreviations as in Figure 1.
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