VENTRIСULAR ECTOPIC ACTIVITY - A PREDICTOR OF SUDDEN CARDIAC DEATH IN PATIENTS WITH ATRIAL FIBRILLATION AND POST-INFARCTION LEFT VENTRICULAR ANEURISMS

Abstract

The article presents a clinical case of a patient who died suddenly from a rapid transformation of ventricular extrasystole into high-grade ectopy during persistent atrial fibrillation. All electrical events preceding death were recorded by the Holter monitor, which the patient was wearing at the time. It was revealed that post-infarction left ventricular aneurysm can be specified as the main predictor of sudden cardiac death, given that the myocardial scar tissue is an arrhythmogenic substrate of pathological re-entry circuits to initiate high-rate ventricular arrhythmias. Heart rate variability and heart rate turbulence, as well as frequent ventricular ectopy plays significant role in the pathological mechanisms of fatal arrhythmias. Complex cardiac arrhythmias combined with changes in the autonomic regulation of the cardiovascular system are early predictors of sudden cardiac death.