ABC Heart Fail Cardiomyop 2022; 2(2): 232-233
Incessant Malignant Ventricular Arrhythmia in a Patient with Advanced Heart Failure: A Case Report
Ciro Mancilha Murad
, Iáscara Wozniak de Campos
Introduction
The occurrence of refractory ventricular arrhythmia in patients with heart failure (HF) is a therapeutic dilemma. These patients, especially in the presence of advanced disease, may experience multiple triggering factors for ventricular arrhythmia, such as myocardial fibrosis, ischemia, hydroelectrolytic disorders, ventricular distention, the arrhythmogenic potential of drugs, and the underlying disease itself.– Conversely, sustained ventricular arrhythmias cause hemodynamic compromise, resulting in further ischemia and ventricular distension. This can lead to a vicious cycle of hemodynamic worsening with an increasingly arrhythmogenic myocardium. Usual treatment consists of direct current (DC) cardioversion, antiarrhythmic drugs, myocardial revascularization (when indicated), and catheter ablation. However, invasive procedures are always considered high risk in such cases. We report the case of a patient with incessant ventricular arrhythmia resistant to several types of treatment.
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