Jun 1, 1986

Mechanisms determining sudden death. A cooperative study of 69 cases recorded using the Holter method

Archives des maladies du coeur et des vaisseaux
J F LeclercqR Slama

Abstract

A cooperative study involving 23 centres enabled review of 69 cases of sudden death occurring less than one hour after onset of symptoms recorded by the Holter method and not related to recent, clinically documented myocardial infarction or to class IV cardiac failure. The 15 cases of asystole (22 p. cent) were observed in elderly patients (73.3 +/- 2.7 years) whose known ischaemic heart disease (12/15) was confirmed in 10 cases as the direct cause by the preceding acute ST changes. In 2 cases, death resulted from AV block presumed to be iatrogenic. The 13 episodes of torsades de point (19 p. cent) occurred mainly in younger women (58.8 +/- 6 years) without apparent cardiac disease (8 cases) and were provoked by a Group IA antiarrhythmic drug (7 cases) or by hypokalemia (3 cases). Apart from 1 case of congenital long QT syndrome, slowing of the sinus rhythm was observed (78.3 +/- 2.6 to 60.2 +/- 2.7 bpm, p less than 0.001) in the 3 hours preceding these episodes, and ventricular bigeminy with a long coupling interval was recorded in the lasts seconds before the torsades. The 41 (59 p. cent) cases of ventricular fibrillation (VF) were observed in men aged 64.9 +/- 2 years with coronary artery disease (39/41). However signs of ac...Continue Reading

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Mentioned in this Paper

Ischemia
Ventricular Fibrillation
Congenital Long QT Syndrome
Coronary Artery Disease
Anti-Arrhythmia Agents
Myocardial Infarction
Sinus - General Anatomical Term
Myocardial Ischemia
Atrial Tachycardia
Coronary Arteriosclerosis

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