Short-coupled idiopathic ventricular fibrillation: A new phenotype? Cuban experience
Abstract
Introduction: Idiopathic ventricular fibrillation triggered by ventricular extrasystoles with short coupling interval has been studied for years, recently it has been proposed as a new phenotype, short-coupled idiopathic ventricular fibrillation.
Objective: To describe the clinical and electrocardiographic evolution of patients with short-coupled idiopathic ventricular fibrillation.
Method: Twelve subjects without structural heart disease demonstrable by conventional methods and idiopathic ventricular fibrillation triggered by extrasystoles with a short coupling interval were studied. The average age was 37.9 years (minimum 15, maximum 60), 6 patients were female and 6 male. Entities that could cause ventricular fibrillation (channelopathies and specific electrical entities) were excluded. Extrasystoles with a short coupling interval (less than or equal to 300 ms), located in the ascending limb or top of the T wave or in its descending limb, and some "not-so-short" were considered.
Results. The onset in all cases was sudden death (ventricular fibrillation), in six patients torsades de pointes were associated. The location of the ventricular extrasystole could vary in the same patient (the lowest value was taken); prevailed in the ascending branch or at the top of the T wave (66.6%, minimum value 220 ms). There were four cases with a "not-so-short" interval. Two patients died, both without implantable cardioverter-defibrillator.
Conclusions: Idiopathic ventricular fibrillation triggered by short coupling ventricular extrasystoles constitutes a new phenotype within the spectrum of malignant ventricular arrhythmias. At shorter intervals, higher malignancy. The association with torsade de pointes is frequent.Downloads
References
1. Belhassen B, Tovia-Brodie O. Short-Coupled Idiopathic Ventricular Fibrillation: A Literature Review With Extended Follow-Up. JACC Clin Electrophysiol. 2022;8(7):918-36. DOI: https://doi.org/10.1016/j.jacep.2022.04.013
2. Steinberg C, Davies B, Mellor G, Tadros R, Laksman ZW, Roberts JD, et al. Short-coupled ventricular fibrillation represents a distinct phenotype among latent causes of unexplained cardiac arrest: a report from the CASPER registry. Eur Heart J. 2021;42(29):2827-38. DOI: https://doi.org/10.1093/eurheartj/ehab275
3. Crea F. Towards precision medicine in the prediction of sudden cardiac death. Eur Heart J. 2021;42(29):2805-7. DOI: https://doi.org/10.1093/eurheartj/ehab476
4. Almehairi M, Alshiekh-Ali AA, Alfagih A. Idiopathic short-coupled ventricular tachyarrhythmias: Systematic review and validation of electrocardiographic indices. Egypt Heart J. 2018;70(4):301-6. DOI: https://doi.org/10.1016/j.ehj.2018.06.003
5. van der Ree MH, Postema PG. What's in a name? Further classification of patients with apparent idiopathic ventricular fibrillation. Eur Heart J. 2021;42(29):2839-41. DOI: https://doi.org/10.1093/eurheartj/ehab382
6. Haïssaguerre M, Shoda M, Jaïs P, Nogami A, Shah DC, Kautzner J, et al. Mapping and ablation of idiopathic ventricular fibrillation. Circulation. 2002;106(8):962-7. DOI: https://doi.org/10.1161/01.cir.0000027564.55739.b1
7. Dorantes Sánchez M, Ponce Paredes EF. Extrasístoles ventriculares con intervalo corto de acoplamiento: Su trascendencia. CorSalud [Internet]. 2015 [citado 10 Oct 2022];7(4):253-7. Disponible en: https://revcorsalud.sld.cu/index.php/cors/article/view/72
8. Dorantes Sánchez M, Ponce Paredes E, Falcón Rodríguez R. Extrasístoles ventriculares con intervalo corto de acoplamiento como detonantes de arritmias malignas. CorSalud [Internet]. 2016 [citado 10 Oct 2022];8(3):144-52. Disponible en: https://revcorsalud.sld.cu/index.php/cors/article/view/134
9. Dorantes Sánchez M, Cruz Cardentey M, Castro Hevia J, Castañeda Chirino O, Martínez López F, Falcón Rodríguez R. Muerte súbita arrítmogénica en sujetos sin cardiopatía estructural demostrable por métodos convencionales. Rev Cuban Cardiol [Internet]. 2021 [citado 12 Oct 2022];27(3):e1133. Disponible en: https://revcardiologia.sld.cu/index.php/revcardiologia/article/view/1133/pdf
10. Dorantes Sánchez M, López Delgado A. Fibrilación ventricular idiopática: un diagnóstico “deslizante”. Parte II. Rev Cuban Cardiol [Internet]. 2011 [citado 12 Oct 2022];17(3):209-17. Disponible en: https://revcardiologia.sld.cu/index.php/revcardiologia/article/view/89/76
11. Leenhardt A, Glaser E, Burguera M, Nürnberg M, Maison-Blanche P, Coumel P. Short-coupled variant of torsade de pointes. A new electrocardiographic entity in the spectrum of idiopathic ventricular tachyarrhythmias. Circulation. 1994;89(1):206-15. DOI: https://doi.org/10.1161/01.cir.89.1.206
12. Dorantes M, Marrero R, Méndez A, Castro J, Vázquez A. Historia familiar de muerte súbita por fibrilación ventricular idiopática. Arch Cardiol Mex. 2014;84(1):57-9. DOI: https://doi.org/10.1016/j.acmx.2013.05.007
13. Steinberg C, Krahn AD. Quinidine vs. ICD therapy in short-coupled ventricular fibrillation-is a randomized trial the next logical step? Eur Heart J. 2021;42(38):3993-4. DOI: https://doi.org/10.1093/eurheartj/ehab614
14. Belhassen B. Quinidine vs. ICD in patients with short-coupled idiopathic ventricular fibrillation: a call for a multicenter randomized trial. Eur Heart J. 2021;42(38):3992. DOI: https://doi.org/10.1093/eurheartj/ehab549
15. Belhassen B, Shauer A. Nine reasons for performing an electrophysiology study in patients with apparently idiopathic ventricular fibrillation. Heart Rhythm. 2022;19(7):1212-3. DOI: https://doi.org/10.1016/j.hrthm.2022.03.010
16. Anderson RD, Kumar S, Kalman JM, Sanders P, Sacher F, Hocini M, et al. Catheter Ablation of Ventricular Fibrillation. Heart Lung Circ. 2019;28(1):110-22. DOI: https://doi.org/10.1016/j.hlc.2018.09.005
17. Haissaguerre M, Cheniti G, Hocini M, Sacher F, Ramirez FD, Cochet H, et al. Purkinje network and myocardial substrate at the onset of human ventricular fibrillation: implications for catheter ablation. Eur Heart J. 2022;43(12):1234-47. DOI: https://doi.org/10.1093/eurheartj/ehab893
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