Case report: electrical storm during induced hypothermia in a patient with early repolarization
نویسندگان
چکیده
BACKGROUND Population based studies showed an association of early repolarization in the electrocardiogram (ECG) and a higher rate of sudden cardiac death presumably due to ventricular fibrillation. The triggers for ventricular fibrillation in patients with early repolarization are not fully understood. CASE PRESENTATION We describe the case of a young patient with a survived ventricular fibrillation arrest while asleep followed by multiple episodes of recurrent ventricular fibrillation. The admission ECG showed an early repolarization pattern with substantial J-point elevation in most of the ECG-leads. After initiation of a hypothermia protocol, the patient developed an electrical storm with multiple ventricular fibrillation episodes requiring multiple cardioversions. Intravenous isoproterenol infusion successfully suppressed the malignant arrhythmia. CONCLUSION Hypothermia appears proarrhythmic in patients with early repolarization and may trigger ventricular fibrillation. This knowledge is particularly important when initiating temperature management protocols in patients after a survived cardiac arrest. During the acute phase of an early repolarization associated electrical storm, isoproterenol is the most effective treatment suppressing the ventricular fibrillation-inducing premature ventricular complexes at higher heart rates.
منابع مشابه
Low room temperature can trigger ventricular fibrillation in J wave syndromes
Recently, much attention has been focused on early repolarization and what has been called the “J wave syndrome,” based on the association between the early repolarization patterns observed in electrocardiograms (ECGs) and the risk of idiopathic ventricular fibrillation (VF), as reported by several researchers. The triggering mechanisms underlying J wave syndromes have not been fully elucidated...
متن کاملTransient J-Wave Appearance in the Inferior-Lateral Leads during Electrical Storm in a Patient with Brugada Syndrome
A 67-year-old male patient was admitted with an abrupt sudden cardiac death. He represented with an extreme electrical storm of 30 times of ventricular fibrillation (VF) episodes on one day. External shocks were performed to terminate VF. Transient J-wave in the inferior-lateral leads and Brugada electrocardiography pattern on the right precordial leads appeared during the electrical storm. And...
متن کاملSuccessful focal ablation in a patient with electrical storm in the early postinfarction period: case report
Electrical storm (ES) is associated with a poor prognosis if it occurs in the early postinfarction period (within 4 weeks). There are limited data on the efficacy and safety of catheter ablation in the early period. In the patients with postinfarction cardiomyopathy, ventricular tachycardia (VT) is usually caused by re-entry through slowly conducting tissue within areas of a myocardial scar, wh...
متن کاملMyocarditis and Meningitis during Early Sepsis in a Neonate with Streptococcus pseudopneumoniae: A Case Report
Although myocarditis is uncommon in neonates, a wide variety of infectious pathogens can result in myocarditis, including viruses, bacteria, rickettsia, fungi, and protozoa. Viruses are most often the infectious disease found to cause acute myocarditis. On the other hand, bacterial myocarditis (BM) is an unusual cause of infectious myocarditis. BM is commonly seen in the context of sepsis or as...
متن کاملA New Nonsense Mutation in CDKL5 Gene in a Male Patient with Early Onset Refractory Epilepsy: a Case Report
Background The X-linked cyclin-dependent kinase like 5 (CDKL5/STK9) gene has been shown to be responsible for a severe encephalopathy condition characterized by early onset of epilepsy and severe developmental delay. CDKL5 mutations have been shown to be more frequent among female patients. Results Here we report a 6- month male patient, second child of a healthy non consanguineous in the Irani...
متن کامل