Chen Hung Yi
Department of Cardiology, Taipei City Hospital-Heping Branch, No. 33, Sec. 2, Zhonghua Rd., Taipei City 100, Taiwan. Email:
Cardiol Res. 2013 Jun;4(3):121-125. doi: 10.4021/cr272e. Epub 2013 Jul 11.
Acute myocardial infarction complicated with lethal cardiac arrhythmia remains the major cause of sudden death. The possible clinical presentation leading to lethal ventricular arrhythmia has been demonstrated but the data are limited. The previous study revealed no significant correlation between sudden cardiac death and the location of coronary obstruction site. And the possible mechanism of sudden cardiac death in non-dominant coronary artery obstruction is unclear. We presented a case of acute myocardial infarction with mid left circumflex artery occlusion complicated with new onset atrial fibrillation initially. The rhythm degenerated into ventricular fibrillation immediately and sudden cardiac death occurred. After resuscitation, he received coronary angioplasty, and the rhythm recovered to sinus after the occluded coronary artery reopened. We thick new onset atrial fibrillation could be a potential risk factor leading to sudden death in acute myocardial infarction with obstruction of non-dominant coronary artery. Control of ventricular rate and early restoration of sinus rhythm may be potential benefit.
急性心肌梗死合并致命性心律失常仍然是猝死的主要原因。导致致命性室性心律失常的可能临床表现已得到证实，但数据有限。先前的研究表明心源性猝死与冠状动脉阻塞部位之间无显著相关性。非优势冠状动脉阻塞时心源性猝死的可能机制尚不清楚。我们报告了1例急性心肌梗死患者，其左回旋支中段闭塞，最初合并新发房颤。节律立即恶化为室颤，发生心源性猝死。复苏后，患者接受了冠状动脉成形术，闭塞的冠状动脉再通后节律恢复为窦性。我们认为新发房颤可能是导致非优势冠状动脉阻塞的急性心肌梗死患者猝死的潜在危险因素。控制心室率和尽早恢复窦性心律可能有益。
