Key result
In a 28-year-old male with idiopathic ventricular fibrillation, Osborn waves in the inferior and precordial leads disappeared after disopyramide administration, suggesting a variant distinct from typical Brugada syndrome.
Why the study?
How do various pharmacological agents and exercise affect Osborn waves in a patient with idiopathic ventricular fibrillation?
Case Report (n=1)
No
How do various pharmacological agents and exercise affect Osborn waves in a patient with idiopathic ventricular fibrillation?
This case suggests that Osborn waves may be strongly associated with the onset of idiopathic ventricular fibrillation and can be modulated by autonomic tone and antiarrhythmic drugs like disopyramide, representing a variant distinct from typical Brugada syndrome.
Should not change practice in idiopathic VF; extends spectrum of Osborn wave phenotypes beyond Brugada syndrome.
症例は28歳, 男性.1998年5月夜間就寝中, 突然うめき声を上げ全身痙攣後, 意識消失に至った.心電図上, 心室細動 (Vf) が確認され, 電気的除細動により洞調律へ復し救命された.本例に基礎心疾患は認められず, ホルター心電図でも心室性期外収縮 (VPC) はまったく認められなかった, 安静時12誘導心電図でII, III, aVFおよびV3～V6誘導にOsborn波 (J波) が認められ, そのJ波高はイソプロテレノールおよび運動負荷で減高, プロプラノロール負荷で増高, メキシレチン, アセチルコリンおよびアトロピン負荷で波高に変化は認めなかった, しかしながら, このJ波は, 従来の報告と異なりジソピラミド負荷で消失した.本例は植込み型除細動器植込み直前, 夜間突然死をきたした.その際, 装着されていたホルター心電図記録より発作はJ波の増強に始まりVPCの頻発からVfに至ったことが確認された.以上より, 本例のVf発症にJ波が強く関与している可能性が示唆され, Brugada症候群とは異なる心電図所見を呈する特発性心室細動の1型として注意すべきものと考えられた.
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Igawa et al. (2003) conducted a case report in Idiopathic ventricular fibrillation with Osborn wave (n=1). Pharmacological testing (including disopyramide) vs. Baseline was evaluated on ECG changes (Osborn wave amplitude). In a 28-year-old male with idiopathic ventricular fibrillation, Osborn waves in the inferior and precordial leads disappeared after disopyramide administration, suggesting a variant distinct from typical Brugada syndrome.
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