Rapporterade fall • Plötslig hjärtdöd

1/3. Arrhythmogenic rätt ventricular kardiomyopati och plötsliga hjärt död i unga koreanerna.

Syftet med denna studie var att bedöma den frekvens och kliniska egenskaper av arrhythmogenic rätt ventricular kardiomyopati (ARVC) i unga offer för plötsliga hjärt död (EKD). Från januari 1999-december 2000 genomfördes postmortem studier i 38 fall av EKD (ålder< or =35 (27+/-7) years old, 26 male) from the taegu-kyungpook region of southeastern korea. cases of sudden infant death syndrome were excluded. the causes of scd were arvc in 42%, acute myocardial infarction in 11%, myocarditis in 11%, pulmonary embolism in 8%, hypertrophic cardiomyopathy in 5%, aortic rupture in 3%, aortic stenosis in 3%, and unknown in 18%. the mean age of the 16 arvc victims was 27+/-5 years and 10 were male. none were competitive athletes, or had been suspected of having cardiovascular disease before death. scd was not related to vigorous physical or competitive activity and occurred during sleep in 7 cases, during work in 4, during bathing in 2, while driving, praying and eating in 1 case each. arvc is an important cause of scd in young people in this area of korea. or="35" (27+/-7)="" years="" old,="" 26="" male)="" from="" the="" taegu-kyungpook="" region="" of="" southeastern="" korea.="" cases="" of="" sudden="" infant="" death="" syndrome="" were="" excluded.="" the="" causes="" of="" scd="" were="" arvc="" in="" 42%,="" acute="" myocardial="" infarction="" in="" 11%,="" myocarditis="" in="" 11%,="" pulmonary="" embolism="" in="" 8%,="" hypertrophic="" cardiomyopathy="" in="" 5%,="" aortic="" rupture="" in="" 3%,="" aortic="" stenosis="" in="" 3%,="" and="" unknown="" in="" 18%.="" the="" mean="" age="" of="" the="" 16="" arvc="" victims="" was="" 27+/-5="" years="" and="" 10="" were="" male.="" none="" were="" competitive="" athletes,="" or="" had="" been="" suspected="" of="" having="" cardiovascular="" disease="" before="" death.="" scd="" was="" not="" related="" to="" vigorous="" physical="" or="" competitive="" activity="" and="" occurred="" during="" sleep="" in="" 7="" cases,="" during="" work="" in="" 4,="" during="" bathing="" in="" 2,="" while="" driving,="" praying="" and="" eating="" in="" 1="" case="" each.="" arvc="" is="" an="" important="" cause="" of="" scd="" in="" young="" people="" in="" this="" area="" of="">korea. cases of sudden infant death syndrome were excluded. the causes of scd were arvc in 42%, acute myocardial infarction in 11%, myocarditis in 11%, pulmonary embolism in 8%, hypertrophic cardiomyopathy in 5%, aortic rupture in 3%, aortic stenosis in 3%, and unknown in 18%. the mean age of the 16 arvc victims was 27+/-5 years and 10 were male. none were competitive athletes, or had been suspected of having cardiovascular disease before death. scd was not related to vigorous physical or competitive activity and occurred during sleep in 7 cases, during work in 4, during bathing in 2, while driving, praying and eating in 1 case each. arvc is an important cause of scd in young people in this area of korea.>

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2/3. Ventricular förmaksflimmer och plötslig död efter radiofrekvensabsorberande kateter ablation av atrioventricular korsningen.

Två hundra trettiofem patienter genomgick RF kateter ablation av AV resistiv för symtomatisk narkotika eldfasta AF (84%), density vibration (9%) och density takykardi (7%). I de första 100 patienterna, var postablation fram inte framåtriktat i en viss takt och var alltid< or="70" beats/min.="" in="" the="" next="" 135="" patients,="" postablation="" pacing="" was="" prospectively="" set="" at="" 90="" beats/min="" for="" 1-3="" months.="" six="" of="" the="" first="" 100="" patients="" (6%)="" had="" vf="" or="" sudden="" death="" after="" the="" rf="" procedure="" and="" none="" (0%)="" of="" the="" next="" 135="" patients="" did="" (p="">< 0.05). one of the six patients had recurrent vf 4 days after the ablation. five patients were successfully resuscitated and one patient died. there were no statistically significant differences between patients with and without (aborted) sudden death or between the first 100 and the next 135 patients with respect to age, sex, underlying heart disease, ef, number of rf applications, or left-or right-sided approach of the procedure. vf mostly occurred during episodes of slow ventricular escape rhythms or during slow ventricular pacing. we conclude that malignant ventricular arrhythmias and sudden death are possible complications of rf ablation of the av function. the mechanism of these complications could have a bradycardia dependent nature and it seems that the occurrence of malignant arrhythmias can be prevented by temporarily pacing the heart at relatively fast rates immediately after ablation. 0.05).="" one="" of="" the="" six="" patients="" had="" recurrent="" vf="" 4="" days="" after="" the="" ablation.="" five="" patients="" were="" successfully="" resuscitated="" and="" one="" patient="" died.="" there="" were="" no="" statistically="" significant="" differences="" between="" patients="" with="" and="" without="" (aborted)="" sudden="" death="" or="" between="" the="" first="" 100="" and="" the="" next="" 135="" patients="" with="" respect="" to="" age,="" sex,="" underlying="" heart="" disease,="" ef,="" number="" of="" rf="" applications,="" or="" left-or="" right-sided="" approach="" of="" the="" procedure.="" vf="" mostly="" occurred="" during="" episodes="" of="" slow="" ventricular="" escape="" rhythms="" or="" during="" slow="" ventricular="" pacing.="" we="" conclude="" that="" malignant="" ventricular="" arrhythmias="" and="" sudden="" death="" are="" possible="" complications="" of="" rf="" ablation="" of="" the="" av="" function.="" the="" mechanism="" of="" these="" complications="" could="" have="" a="" bradycardia="" dependent="" nature="" and="" it="" seems="" that="" the="" occurrence="" of="" malignant="" arrhythmias="" can="" be="" prevented="" by="" temporarily="" pacing="" the="" heart="" at="" relatively="" fast="" rates="" immediately="" after="">

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3/3. Plötslig hjärt död är associerad med hypoplasi av födans artärer och resistiv system ändring.

Vi presenterar ett fall av plötslig hjärt död i en 24-årig kvinna med bevis på hypoplasi vänster främre fallande (LAD) och bakre fallande (PDA) födans artärer. Dessa fartyg i genomsnitt 0,7 mm innerdiameter kombinerade, i motsats till ett genomsnitt på 2,4 mm i kontroll födans artärer (p< 0.001). the myocardium exhibited areas of acute and chronic ischemic change. also, the cardiac conduction system (ccs) had diffuse cellular enlargement, believed to be secondary to ischemia. the cells of the sinoatrial node (san) and the purkinje cells of the proximal right bundle branch (rbb) averaged 28.5 and 25.6 microns, respectively. these were significantly larger than the san cells (21.6 microns, p = 0.002) and larger than the purkinje cells (15.9 microns, p = 0.012) of control cases. we report that hypoplastic coronary artery disease is a cause of sudden death, is associated with varying degrees of ischemic change in the heart, and can be associated with condition system alteration. 0.001).="" the="" myocardium="" exhibited="" areas="" of="" acute="" and="" chronic="" ischemic="" change.="" also,="" the="" cardiac="" conduction="" system="" (ccs)="" had="" diffuse="" cellular="" enlargement,="" believed="" to="" be="" secondary="" to="" ischemia.="" the="" cells="" of="" the="" sinoatrial="" node="" (san)="" and="" the="" purkinje="" cells="" of="" the="" proximal="" right="" bundle="" branch="" (rbb)="" averaged="" 28.5="" and="" 25.6="" microns,="" respectively.="" these="" were="" significantly="" larger="" than="" the="" san="" cells="" (21.6="" microns,="" p="0.002)" and="" larger="" than="" the="" purkinje="" cells="" (15.9="" microns,="" p="0.012)" of="" control="" cases.="" we="" report="" that="" hypoplastic="" coronary="" artery="" disease="" is="" a="" cause="" of="" sudden="" death,="" is="" associated="" with="" varying="" degrees="" of="" ischemic="" change="" in="" the="" heart,="" and="" can="" be="" associated="" with="" condition="" system="">is a cause of sudden death, is associated with varying degrees of ischemic change in the heart, and can be associated with condition system alteration.>

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