Abstract
Idiopathic ventricular fibrillation is responsible for ≈5%-7% of aborted cardiac arrest,
mainly striking subjects in their forties. Syncope caused by short-coupled rapid polymorphic
ventricular tachycardia is frequently noted in a patient's past history. However,
a diagnosis of neurally mediated syncope, the most frequent cause of syncope in the
young, is often erroneously made. Clinical clues suggest that syncope has an arrhythmic
rather than a neurally mediated origin. In addition, the presence of premature ventricular
contractions on an electrocardiogram recorded shortly after a syncopal event has utmost
importance in establishing the cause of syncope. Although such extrasystoles are frequently
benign, especially when associated with a long coupling interval, they also may suggest
a malignant origin when closely coupled to the preceding complex with short coupling
intervals (usually <350 ms). These arrhythmias mainly originate from the Purkinje
system (usually the right ventricle in men and the left ventricle in women) and favorably
respond to quinidine as well as to ablation therapy targeting Purkinje-fibers ectopic
activity.
Keywords
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References
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Article Info
Publication History
Published online: July 22, 2022
Publication stage
In Press Journal Pre-ProofFootnotes
Funding: None.
Conflicts of Interest: None.
Authorship: Both authors had access to the data and a role in writing this manuscript.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
