A 39-year-old woman showed nonsustained polymorphic ventricular tachycardia (PVT) during light physical activity. Cardiac multidetector row computed tomography demonstrated false tendons, one of which proved to be the focus triggering premature ventricular contraction (PVC) in electrophysiological studies. The triggered PVC arose during the diastolic period, which might have caused tension in the false tendon. Radiofrequency catheter ablation targeting the triggered PVC by pace mapping was performed and proved partially effective against PVT.

In a large population of age- and gender-matched groups, both ERS and BrS patients showed attenuated QT-rate dependence and impaired QT day-night modulation that may provide a baseline reentrant substrate. Importantly, QT/RR maladaptation was most evident at mid-night and early morning, which may explain the propensity of such patients to develop SCD during this critical period.

No abstract

We describe three cases of J-wave syndrome in which ventricular fibrillation (VF) was probably induced by corticosteroid therapy. The patients involved were being treated with prednisolone for concomitant bronchial asthma. One of the three patients had only one episode of VF during her long follow-up period (14 years). Two patients had hypokalemia during their VF episodes. Corticosteroids have been shown to induce various types of arrhythmia and to modify cardiac potassium channels. We discuss the possible association between corticosteroid therapy and VF in J-wave syndrome based on the cases we have encountered.

We report a case of clonic-tonic seizures diagnosed using an implantable loop recorder, a device for detecting cardiac arrhythmias. A 65-year-old man was referred to our hospital for loss of consciousness with myotonic jerks during sleep. He had experienced several similar episodes. No family history of sudden death was evident, and no structural heart disease was present. Coronary angiography with intracoronary acetylcholine (ACh) showed neither organic stenosis nor vasospastic angina. Ventricular tachyarrhythmias were not induced by programmed electrical stimuli. Sleep electroencephalography, brain magnetic resonance imaging and magnetic resonance angiography revealed no specific findings. We implanted a loop recorder to monitor rhythm abnormalities. One month later, an attack occurred at night. His wife recognized the episode and activated the implantable loop recorder. No arrhythmia was recorded, but myopotentials characteristic of tonic-clonic seizures were detected. (J Arrhythmia 2011; 27: 76-79)