Журнал биоэквивалентности и биодоступности

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Therapeutic Management in the Idiopathic Ventricular Fibrillation: Is there Still a Place for Pharmacological Treatment?

Osmar Antonio Centurión

Sudden cardiac death in the truly normal heart is an uncommon occurrence. The majority of patients without apparent structural heart disease who died suddenly do not actually have “normal” hearts. Idiopathic ventricular fibrillation (IVF) is an uncommon disease of unknown etiology that manifests as syncope, cardiac arrest or seizures caused by rapid polymorphic ventricular tachycardia (VT) or VF in the absence of structural heart disease or identifiable channelopathy. Usually during an arrhythmic storm, it is relatively easy to diagnose IVF in a cardiac arrest survivor when the onset of spontaneous polymorphic VT/VF can be recorded, and this shows initiation of polymorphic VT/VF by very short coupled ventricular ectopy. IVF is essentially a diagnosis by exclusion. However, typical clinical and electrophysiological characteristics present in some patients often allows for a positive diagnosis. Since the rate of recurrence of malignant ventricular arrhythmias in IVF is unacceptably high in the absence of therapy, once a diagnosis of IVF is made, some form of therapy is mandatory. Therapy may include ICD implantation, drug therapy, radiofrequency catheter ablation of the triggering focus or combinations of the above. This article will discuss the role of pharmacological treatment in the therapeutic management of IVF. Is there still a place for pharmacological treatment in IVF? Yes, there is still a place for pharmacological treatment in the therapeutic armamentarium of IVF in carefully selected, individually well documented patients.