The Spectrum of Idiopathic Ventricular Fibrillation and J-Wave Syndromes: Novel Mapping Insights

Card Electrophysiol Clin. 2019 Dec;11(4):699-709. doi: 10.1016/j.ccep.2019.08.011.

Abstract

Idiopathic ventricular fibrillation and J-wave syndromes are causes of sudden cardiac death (SCD) without any identified structural cardiac disease after extensive investigations. Recent data show that high-density electrophysiological mapping may ultimately offer diagnoses of subclinical diseases in most patients including those termed "unexplained" SCD. Three major conditions can underlie the occurrence of SCD: (1) localized depolarization abnormalities (due to microstructural myocardial alteration), (2) Purkinje abnormalities manifesting as triggering ectopy and inducible reentry; or (3) repolarization heterogeneities. Each condition may result from a spectrum of pathophysiologic processes with implications for individual therapy.

Keywords: Early repolarization syndromes; J-wave syndromes; Purkinje system; Sudden cardiac death; Ventricular fibrillation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Brugada Syndrome* / complications
  • Brugada Syndrome* / diagnostic imaging
  • Brugada Syndrome* / physiopathology
  • Death, Sudden, Cardiac / etiology
  • Electrocardiography
  • Electrophysiologic Techniques, Cardiac*
  • Heart Conduction System / diagnostic imaging
  • Heart Conduction System / physiopathology
  • Humans
  • Ventricular Fibrillation* / complications
  • Ventricular Fibrillation* / diagnostic imaging
  • Ventricular Fibrillation* / physiopathology

Supplementary concepts

  • Paroxysmal ventricular fibrillation