Storms of Ventricular Fibrillation Responsive to Isoproterenol in an Idiopathic Ventricular Fibrillation Patient Demonstrating Complete Right Bundle Branch Block

Yoshiyasu Aizawa; Seiji Takatsuki; Kohei Inagawa; Yoshinori Katsumata; Takahiko Nishiyama; Takehiro Kimura; Nobuhiro Nishiyama; Kotaro Fukumoto; Yoko Tanimoto; Kojiro Tanimoto; Satoshi Ogawa; Keiichi Fukuda

doi:10.1536/ihj.54.240

Case Reports

Storms of Ventricular Fibrillation Responsive to Isoproterenol in an Idiopathic Ventricular Fibrillation Patient Demonstrating Complete Right Bundle Branch Block

Yoshiyasu Aizawa, Seiji Takatsuki, Kohei Inagawa, Yoshinori Katsumata, Takahiko Nishiyama, Takehiro Kimura, Nobuhiro Nishiyama, Kotaro Fukumoto, Yoko Tanimoto, Kojiro Tanimoto, Satoshi Ogawa, Keiichi Fukuda

Author information

Yoshiyasu Aizawa
Department of Cardiology, Keio University School of Medicine
Seiji Takatsuki
Department of Cardiology, Keio University School of Medicine
Kohei Inagawa
Department of Cardiology, Keio University School of Medicine
Yoshinori Katsumata
Department of Cardiology, Keio University School of Medicine
Takahiko Nishiyama
Department of Cardiology, Keio University School of Medicine
Takehiro Kimura
Department of Cardiology, Keio University School of Medicine
Nobuhiro Nishiyama
Department of Cardiology, Keio University School of Medicine
Kotaro Fukumoto
Department of Cardiology, Keio University School of Medicine
Yoko Tanimoto
Department of Cardiology, Keio University School of Medicine
Kojiro Tanimoto
Department of Cardiology, Keio University School of Medicine
Satoshi Ogawa
International University of Health and Welfare, Mita Hospital
Keiichi Fukuda
Department of Cardiology, Keio University School of Medicine

Keywords: Sudden death, Implantable cardioverter defibrillator, Electrocardiogram, Catheter ablation, Electrical storm, Bepridil

JOURNAL FREE ACCESS

2013 Volume 54 Issue 4 Pages 240-242

DOI https://doi.org/10.1536/ihj.54.240

Details

Abstract

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.

Corresponding author

Register with J-STAGE for free!