Analysis of ambulatory electrocardiograms in 15 patients during spontaneous ventricular fibrillation with special reference to preceding arrhythmic events

Craig Pratt, Marilyn J. Francis, Jerry C. Luck, Christopher R. Wyndham, Richard R. Miller, Miguel A. Quiñones

Research output: Contribution to journalArticle

142 Scopus citations

Abstract

Fifteen patients sustained ventricular fibrillation during ambulatory electrocardiographic recording in a period of 3.5 years over which time 16,500 ambulatory electrocardiograms were analyzed (prevalence = 0.09% or 1/1,100). Eight patients died, and seven survived cardiopulmonary resuscitation. Quantitative analysis of hourly ventricular arrhythmias prior to ventricular fibrillation revealed an increased frequency of premature ventricular beats and ventricular tachycardia, especially in the 2 hours immediately before ventricular fibrillation. Ventricular fibrillation was initiated by ventricular tachycardia in all 15 cases. These runs of ventricular tachycardia were characterized by their unusual length (mean = 560 ± 536 beats) and their rapid rate (241 ± 45 beats/min). Although an R on T premature ventricular beat initiated ventricular tachycardia and ventricular fibrillation occasionally, the mean prematurity index of the initiating premature ventricular beat was not early (mean = 1.27 ± 0.28). QT prolongation was present in only 3 of the 15 patients (mean QTc interval = 0.42 ± 0.06). Left ventricular dysfunction (mean left ventricular ejection fraction = 34.9 ± 9.9%) and coronary artery disease were nearly always present. The cardiac medications most frequently associated with these patients at the time of ventricular fibrillation were digitalis and quinidine.

Original languageEnglish (US)
Pages (from-to)789-797
Number of pages9
JournalJournal of the American College of Cardiology
Volume2
Issue number5
DOIs
StatePublished - Jan 1 1983

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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