SELECTIVE RIGHT-VENTRICULAR ANGIOGRAPHY IN APPARENTLY IDIOPATHIC VENTRICULAR-FIBRILLATION

The definition of underlying heart disease in apparently idiopathic ve ntricular fibrillation seems to be important in regard to prognosis an d choice of therapy. From October 1989, until August 1993, cardiac arr est due to the documented ventricular fibrillation occurred in eight c onsecutive patients with normal results on clinical examination, norma l echocardiography, and normal or apparently nonspecific electrocardio gram (EGG) findings. Complete invasive investigations, including selec tive right ventricular angiography, were done; regional hypokinesia an d segmental bulging of the right ventricle were found in seven patient s (88%). Arrhythmogenic right ventricular dysplasia was suspected in t hese patients, although endomyocardial biopsy was not performed. After the finding of localized right precordial QRS prolongation of more th an 110ms in November 1993 in five patients, a retrospective, a more pr ecise approach to QRS duration in standard ECG supported this diagnosi s. Selective right ventricular angiography is of great help in identif ying underlying heart disease in patients with apparently idiopathic V entricular fibrillation, and confirms ECG findings.