• Int Heart J · Mar 2019

    Case Reports

    Pulseless Electric Activity with Pre-Excitation.

    • Tsukasa Oshima, Katsuhito Fujiu, Jun Matsuda, Takumi Matsubara, Eriko Hasumi, Oguri Gaku, Toshiya Kojima, and Issei Komuro.
    • Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo.
    • Int Heart J. 2019 Mar 20; 60 (2): 470-473.

    AbstractA 41-year-old man developed cardiac arrest. A resting 12-lead electrocardiogram showed a delta wave, suggestive of preexcitation syndrome. An electrophysiological test revealed the existence of inducible atrial fibrillation and a fasciculoventricular accessory pathway (FVAP). After these examinations, idiopathic ventricular arrhythmia was suspected. For evaluating concealed Brugada syndrome, pilsicainide was administered, which diminished the delta wave and no Brugada-like electrocardiogram was observed. Ventricular double extra-stimulation from the RV apex easily induced VF, which could not be defibrillated by an external defibrillator, and later stopped spontaneously. These results established the diagnosis of FVAP and idiopathic VF, and not pre-excited atrial fibrillation or Brugada syndrome.

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