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[Mechanisms determining sudden death. A cooperative study of 69 cases recorded using the Holter method].
Arch Mal Coeur Vaiss. 1986 Jun; 79(7):1024-33.AM

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 acute ischaemia were only found in 5 cases. The VF was primary in 8 cases and secondary to ventricular tachycardia (VT in 33 cases). An acceleration of the cardiac rhythm (83.3 +/- 3.4 to 90 +/- 4.1 bpm, p less than 0.01) was recorded in the hour preceding VF and other arrhythmias were common: atrial tachycardia (4 cases), atrial extrasystoles (4 cases), a new type of ventricular extrasystoles (VES). The VF and VT were preceded by a long cycle in 17 cases. The first complex was different from previous VES in 10 cases and identical to the previous VES in 16 cases; in 4 cases this feature could not be identified and in 11 cases there were no premonitory VES. The coupling interval of the initial VES was shorter than that of the most premature preceding VES (368 +/- 13 ms vs 442 +/- 19 ms, p less than 0.001), especially in primary VF (335 +/- 9 ms, N = 8) compared to polymorphic VT (360 +/- 12 ms, N = 11) or monomorphic VT (384 +/- 18 ms N = 22).(ABSTRACT TRUNCATED AT 250 WORDS)

Authors

Leclercq JF
No affiliation info available
Coumel P
No affiliation info available
Maison-Blanche P
No affiliation info available
Cauchemez B
No affiliation info available
Zimmermann M
No affiliation info available
Chouty F
No affiliation info available
Slama R
No affiliation info available

MeSH

AgedCoronary DiseaseDeath, SuddenElectrocardiographyFemaleHeart ArrestHumansMaleMiddle AgedMonitoring, PhysiologicMyocardial InfarctionTachycardiaVentricular Fibrillation

Pub Type(s)

Comparative Study
English Abstract
Journal Article
Research Support, Non-U.S. Gov't

Language

fre

PubMed ID

3096225

Citation

Leclercq, J F., et al. "[Mechanisms Determining Sudden Death. a Cooperative Study of 69 Cases Recorded Using the Holter Method]." Archives Des Maladies Du Coeur Et Des Vaisseaux, vol. 79, no. 7, 1986, pp. 1024-33.
Leclercq JF, Coumel P, Maison-Blanche P, et al. [Mechanisms determining sudden death. A cooperative study of 69 cases recorded using the Holter method]. Arch Mal Coeur Vaiss. 1986;79(7):1024-33.
Leclercq, J. F., Coumel, P., Maison-Blanche, P., Cauchemez, B., Zimmermann, M., Chouty, F., & Slama, R. (1986). [Mechanisms determining sudden death. A cooperative study of 69 cases recorded using the Holter method]. Archives Des Maladies Du Coeur Et Des Vaisseaux, 79(7), 1024-33.
Leclercq JF, et al. [Mechanisms Determining Sudden Death. a Cooperative Study of 69 Cases Recorded Using the Holter Method]. Arch Mal Coeur Vaiss. 1986;79(7):1024-33. PubMed PMID: 3096225.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Mechanisms determining sudden death. A cooperative study of 69 cases recorded using the Holter method]. AU - Leclercq,J F, AU - Coumel,P, AU - Maison-Blanche,P, AU - Cauchemez,B, AU - Zimmermann,M, AU - Chouty,F, AU - Slama,R, PY - 1986/6/1/pubmed PY - 1986/6/1/medline PY - 1986/6/1/entrez SP - 1024 EP - 33 JF - Archives des maladies du coeur et des vaisseaux JO - Arch Mal Coeur Vaiss VL - 79 IS - 7 N2 - 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 acute ischaemia were only found in 5 cases. The VF was primary in 8 cases and secondary to ventricular tachycardia (VT in 33 cases). An acceleration of the cardiac rhythm (83.3 +/- 3.4 to 90 +/- 4.1 bpm, p less than 0.01) was recorded in the hour preceding VF and other arrhythmias were common: atrial tachycardia (4 cases), atrial extrasystoles (4 cases), a new type of ventricular extrasystoles (VES). The VF and VT were preceded by a long cycle in 17 cases. The first complex was different from previous VES in 10 cases and identical to the previous VES in 16 cases; in 4 cases this feature could not be identified and in 11 cases there were no premonitory VES. The coupling interval of the initial VES was shorter than that of the most premature preceding VES (368 +/- 13 ms vs 442 +/- 19 ms, p less than 0.001), especially in primary VF (335 +/- 9 ms, N = 8) compared to polymorphic VT (360 +/- 12 ms, N = 11) or monomorphic VT (384 +/- 18 ms N = 22).(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0003-9683 UR - https://www.unboundmedicine.com/medline/citation/3096225/[Mechanisms_determining_sudden_death__A_cooperative_study_of_69_cases_recorded_using_the_Holter_method]_ DB - PRIME DP - Unbound Medicine ER -