Ventricular Tachycardia and Ventricular Fibrillation in Patients with Short P‐R Intervals and Narrow QRS Complexes

ROBERT J. MYERBURG, RUEY J. SUNG, AGUSTIN CASTELLANOS

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Eleven patients with short P-R intervals and narrow QRS complexes had ventricular tachycardia due to organic heart disease: mitral valve prolapse with mitral insufficiency (2 patients); alcoholic (?) cardiomyopathy (2 patients); and coronary artery disease (7 patients). Intracardiac studies showed short A-H intervals during sinus rhythm in all cases. The onset of ventricular fibrillation (which, to our knowledge, has not been observed in patients having short P-R and A-H intervals co-existing with narrow QRS complexes) was documented in 4 cases. Only 1 patient (with quinidine syncope) had been premedicated. In the 3 other patients the episodes of ventricular fibrillation appeared during bouts of atrial fibrillation with rapid ventricular rates which could have been an expression of the 'enhanced A-V conduction' that had been manifested in sinus beats by short P-R and A-H intervals. In clinical settings and physiological conditions proven to be hemodynamically unstable (such as transient ischemia or acute myocardial infarction) these rapid ventricular rates could have led to ventricular fibrillation; directly because of the R-on-T phenomenon, and/or indirectly due to decreased coronary perfusion. Ventricular tachycardia and ventricular fibrillation due to organic heart disease probably occur more often than suggested by the few reported cases in the literature. Its significance, however, has to be clarified by further prospective studies.

Original languageEnglish (US)
Pages (from-to)568-578
Number of pages11
JournalPacing and Clinical Electrophysiology
Volume2
Issue number6
DOIs
StatePublished - Nov 1979

Keywords

  • His bundle recording
  • Lown‐Ganong‐Levine syndrome
  • short P‐R interval
  • sudden death
  • ventricular fibrillation
  • ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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