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2021, Number 3

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Rev Cubana Cardiol Cir Cardiovasc 2021; 27 (3)

Sudden arrhythmogenic death in subjects without demonstrable structural heart disease by conventional methods

Dorantes SM, Cruz CM, Castro HJ, Castañeda CO, Martínez LF, Falcón RR, de Zayas GJ, Mengana BA, de la Vega VK

Language: Spanish
References: 46
Page: 1-8
PDF size: 726.04 Kb.


ABSTRACT

Introduction: Arrhythmogenic sudden cardiac death in subjects without structural heart disease demonstrable by conventional methods is a major clinical and public health conflict for the international cardiology community.
Objective: Characterize patients with apparently normal hearts, resuscitated from episodes of arrhythmogenic sudden death.
Method: During 20 years (2000-2020), the National Registry of 138 patients with an apparent normal heart, resuscitated from episodes of arrhythmogenic sudden death and admitted to the Arrhythmia and Cardiac Pacing Service, was carried out for study, diagnosis and treatment.
Results: The most common electrical entity was idiopathic ventricular fibrillation (29.7%, a diagnosis that may change over time as evidence of a specific subpopulation appears); followed by Brugada syndrome (22.5%). 73.2% corresponded to channelopathies as a whole. The arrhythmia causing death was ventricular fibrillation (43.8%), followed by tip torsion (14.7%). There were recurrences in 76.1%, which requires prompt therapeutic measures. Premonitory electrical signs were frequent (74.6%), neither absolute nor negligible. Electrical stimulation was performed in 50 patients, only in 10 (20%) it was possible to induce arrhythmia (low frequency compared to other series, we have no explanation for it because the protocols were similar), the therapeutic decision was not based solely on in this studio.
Conclution: Idiopathic ventricular fibrillation and Brugada and long QT syndromes are the most frequent electrical entities in these patients, and ventricular fibrillation the arrhythmia responsible for sudden death in most cases. Relapses and predictive electrical signs are very common; electrical stimulation has value although there are false positives and negatives and alone should not decide the therapeutic conduct.


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