Defibrillators: Idiopathic Ventricular Fibrillation

BREAKING NEWS: 10.15.07--Medtronic, Inc., the world's largest maker of electronic heart devices, announced they are suspending sales of Sprint Fidelis leads. According to the FDA, these wires, used to connect defibrillators to the heart, may break or erode and may increase chance of injury. Learn more about the Medtronic Sprint Fidelis Recall.

Ventricular fibrillation that occurrs in a structurally normal heart is classified as "primary electrical disease" or "idiopathic ventricular fibrillation." This suggests that the cause or trigger lies within some property of the conducting system of the heart.

The model of "primary electrical disease" is the long QT syndrome (LQTS) in which the altered membrane ionic channel function underlies QT prolongation. The altered channel activity is due to mutations in genes encoding ion channels [Kass RS et al. 1996].

In 1992, Brugada and Brugada described a small group of 8 patients with a history of aborted sudden death and a distinctive ECG consisting of right bundle branch block with ST elevation in the right precordial leads and a normal QT interval. Structural heart was absent as determined clinically, biochemically and by echocardiographic and angiographic examinations [Brugada P et al. 1992].

Interestingly, the ECG pattern was dynamic and modifiable by changes in autonomic tone and antiarrhythmic drugs. It has been suggested that "[m]arked dispersion of refractoriness of cardiac tissue or extreme anisotropic conduction properties of the conduction system and the ventricular muscle" represent the underlying pathophysiological abnormality [Brugada P et al. 1992].

Similar findings have also been described in a sub-group of males in southern Asia. In north-eastern Thailand, sudden unforseen deaths generally occurring during sleep have been described in young men, many of whom have a family history [Tatsanavivat P et al. 1992].

These syndromes provide for an interesting field of studying the mechanisms of the initiation and maintenance of ventricular fibrillation without the need to consider extrinsic initiators. The study of these patients may assist to further determine the mechanisms of ventricular fibrillation.

If your or a loved has had an implantable cardioverter-defibrillator such as the recalled Guidant:

1. CONTAK RENEWAL 2, Model H155

2. CONTAK RENEWAL, Model H135, or

3. PRIZM 2 DR, Model 1861

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see also:

Ischaemic Myocardium Ischaemic Myocardium & Defibrillators: Have You Been Hurt?
Free legal review of your Ischaemic Myocardium & Defibrillator

Characteristics Guidant Injury? Characteristics of Ventricular Fibrillation
Guidant: Characteristics of the Ventricular Fibrillation Waveform

Learn More Dangerous Recalled PRIZM 2 DR, Model 1861
Legal help for men and women with the dangerous PRIZM defibrillator