Aizawa Yoshiyasu, Takatsuki Seiji, Inagawa Kohei, Katsumata Yoshinori, Nishiyama Takahiko, Kimura Takehiro, Nishiyama Nobuhiro, Fukumoto Kotaro, Tanimoto Yoko, Tanimoto Kojiro, Ogawa Satoshi, Fukuda Keiichi
Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
Int Heart J. 2013;54(4):240-2. doi: 10.1536/ihj.54.240.
A 45-year-old male was admitted to our hospital after successful resuscitation of cardiac arrest. Ventricular fibrillation (VF) had occurred during breakfast and was defibrillated by an automated external defibrillator operated by emergency medical service staff. On admission, his ECG demonstrated complete right bundle branch block as the sole abnormality. Intensive examination could not detect any structural disease leading to a diagnosis of idiopathic VF and implantation of an ICD. VF storm occurred one month after hospital discharge and beta-blocker, amiodarone, and sedative administration had no effect on VF. Likewise, catheter ablation for triggering premature ventricular beats failed to control the VF storm. The VF storm then subsided in the following weeks and the patient was discharged on amiodarone. A half month later VF storm recurred and the patient was admitted again. This time, isoproterenol infusion was effective in suppressing VF, and thereafter the patient was administered bepridil and followed up without recurrence of VF for 1.5 years. From these beneficial effects, the VF of the patient was suggested to share common arrhythmogenic characteristics to those of Brugada syndrome or J-wave associated VF.
一名45岁男性在心脏骤停成功复苏后被收入我院。早餐时发生室颤（VF），由紧急医疗服务人员操作自动体外除颤器进行除颤。入院时，他的心电图显示完全性右束支传导阻滞为唯一异常。详细检查未发现任何结构性疾病，诊断为特发性VF并植入了植入式心律转复除颤器（ICD）。出院后1个月发生VF风暴，给予β受体阻滞剂、胺碘酮和镇静剂治疗对VF均无效。同样，针对触发室性早搏的导管消融也未能控制VF风暴。随后VF风暴在接下来的几周内消退，患者出院时服用胺碘酮。半个月后VF风暴复发，患者再次入院。此次，静脉输注异丙肾上腺素有效抑制了VF，此后患者服用苄普地尔，随访1.5年未再发生VF。基于这些有益效果，提示该患者的VF与Brugada综合征或J波相关VF具有共同的致心律失常特征。
