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ELECTROCARDIOGRAPHIC ANALYSIS OF INDUCED VENTRICULAR FIBRILLATION
  • Juan José Sánchez-Muñoz
Juan José Sánchez-Muñoz
University Hospital Virgen Arrixaca
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Abstract

Introduction: Ventricular fibrillation ECG is characterized by the presence of irregular QRS complexes, with variable morphology, amplitude and frequency. Aims: Analyze the electrocardiographic characteristic of induced sustained VF (ISVF) . Methods: The 12 lead ECG of ISVF was analyzed in 8 patients with coronary artery disease (CAD) and 7 with Brugada Syndrome (BS). The ECG was divided into triggers and two tachysystolic and sinusoidal phases, based on Wiggers’ stages. Results: Triggers: Four QRS morphologies: similar to stimulated (IR); LBBB with superior axis (SA) (suggesting origin in moderate band of the right ventricle (MB); RBBB with superior left axis (SLA) (suggesting origin in posteromedial papillary muscle (PPM) predominant in CAD; and LBBB with inferior axis (IA) (suggesting origin in RVOT) predominant in BS. Tachysystolic stage: there is a predominant morphology with RBBB and SA in CAD; and morphologies with LBBB and IA in BS. Sinusoidal stage: Complexes of small amplitude with notches appeared in SVF, but not in non-sustained VF. Conclusions: The ECG at the onset and tachysystolic stage of ISVF shows morphologies which may be related to the activation of MB, PPM and RVOT. The notches could be a predictor of SVF .