Evolving J waves prior to ventricular fibrillation postoperative coronary bypass

Intern Med. 2011;50(20):2337-40. doi: 10.2169/internalmedicine.50.5934. Epub 2011 Oct 15.

Abstract

A 74-year-old man without history of ventricular arrhythmias underwent coronary bypass surgery for 3-vessel disease. On the 4th postoperative day, he developed ventricular fibrillation (VF). His monitored ECG showed no elevation of the ST-segment and no prolongation of QT interval, but evolving J waves prior to VF were shown. These J waves gradually decreased after defibrillation. The subsequent angiography revealed patent grafts and normal left ventricular function. J waves reappeared in inferior leads when contrast medium was injected into the coronary artery. Therefore, evolving J wave can be a marker of latent ischemia and a predictor of VF.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Coronary Artery Bypass*
  • Electrocardiography*
  • Humans
  • Male
  • Postoperative Complications / physiopathology*
  • Preoperative Period
  • Ventricular Fibrillation / physiopathology*