Amiodarone Induced Ventricular Fibrillation in Unveiled WPW Syndrome: A Resource-Limited Setting Dilemma.
Amiodarone Induced Ventricular Fibrillation in Unveiled WPW Syndrome: A Resource-Limited Setting Dilemma.
Where did the research take place?
The study site has not been established. Author addresses may differ from where the research occurred.
Jember, ID · Author affiliation
Citra Husada Jember Hospital, Jember, East Java, Indonesia. Electronic address: fadhlanabdurrahman@gmail.com.Location evidence
Surabaya, ID · Author affiliation
Department of Cardiology and Cardiac Electrophysiology, Dr. Soetomo Regional General Hospital, Surabaya, East Java, Indonesia.Location evidence
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Original abstract
BACKGROUND: Wolff-Parkinson-White (WPW) syndrome predisposes patients to life-threatening tachyarrhythmias due to rapid ventricular activation via an accessory pathway. Malignant arrhythmias may occur unexpectedly, even in previously asymptomatic individuals. CASE SUMMARY: A 36-year-old man presented with sudden palpitations and a regular wide-complex tachycardia consistent with antidromic atrioventricular reentrant tachycardia. The rhythm rapidly deteriorated into preexcited atrial fibrillation and progressed to ventricular fibrillation cardiac arrest requiring immediate defibrillation and cardiopulmonary resuscitation, with successful return of spontaneous circulation. Postresuscitation electrocardiography demonstrated persistent ventricular preexcitation. Electrophysiological study subsequently confirmed a left lateral accessory pathway, and successful radiofrequency catheter ablation resulted in complete resolution of ventricular preexcitation. DISCUSSION: This case highlights the malignant electrophysiological behavior of WPW and the diagnostic and therapeutic challenges of wide-complex tachycardia, particularly in resource-limited settings. TAKE-HOME MESSAGES: WPW may rapidly progress from antidromic atrioventricular reentrant tachycardia to ventricular fibrillation. Early recognition, prompt electrical cardioversion/defibrillation, and timely referral for catheter ablation are critical.