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European Heart Journal 1987 8(8):912-916;
Copyright © 1987 by the European Society of Cardiology.
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© 1987 The European Society of Cardiology

Ventricular fibrillation induced by transesophageal atrial pacing in hypertrophic cardiomyopathy

S. FAVALE, M. DI BIASE, U. RIZZO, F. MINAFRA and P. RIZZON

Division of Cardiology, University of Bari Bari, Italy

Received 4 August 1986; revised 2 December 1986; .

Dr Stefano Favale, Clinica Medica I, Cardiologia, Policlinico 70124 Bari, Italy.

Sudden death is a rather frequent occurrence in patients with hypertrophic cardiomyopathy, yet the mechanism is uncertain in most cases. We describe a case of an 18 years old patient with a family history of hypertrophic cardiomyopathy and sudden death in whom ventricular fibrillation could be repeatedly induced by means of transesophageal atrial stimulation with 1 : 1 AV conduction at a rate of 200 beats min-1 and prevented by pharmacological depression of AV node. The not particularly high ventricular rate at which VF occurred could suggest that in hypertrophic cardiomyopathy a major role in favouring VF induction is played by the electro-physiological properties of the myocardium and that sudden death can occur as a consequence of different atrial tachyarrhythmias.

Key Words: Hypertrophic cardiomyopathy, • ventricular fibrillation, • atrial pacing.


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