Ventricular Fibrillation

What is the relationship between an easily induced ventricular tachycardia and ventricular fibrillation in the EP lab and the likelihood of going into ventricular fibrillation spontaneously requiring firing of the ICD?  This is in a person with nonischemic dilated cardiomyopathy having an EF of 30%.  Which electrolytes are crucial to keep in a normal range in preventing this life threatening arrhythmia or are they all equally important?  I am thinking of KCl, Mg, Calcium.  Taking diuretics, I find these electrolytes are often out of range.

Thank you for your insight.  I learn so much from your answers to the many postings.

[Cleveland Clinic]

rick,

thanks for the post.

There isnt a lot of data on the subsequent risk of developing a malignant arrythmia in those that have inducible VT/VF during EP testing.  However, it is thought that those that have inducible arrythmias in the EP lab are at higher risk.  Given this, inducible VT/VF was initially incorporated into many of the trials looking at the benefits of ICD therapy.

Since then, we've seen less of an emphasis placed on this particular criteria as benefit is seen even in patients without testing.  More recently, data has suggested that ICDs may be beneficial in patients with nonischemic cardiomyopathy and an EF below 35%.  There are some reimbursment issues, but this is a very important topic and you should discuss it with your EP.

All electrolytes are important to cardiac rhythm and significant alterations of any of them can predispose patients to an arrythmia.

hope this is a start

[Kristin391]

I was told that the VT/VF was very easily inducible.  Is there any know correlation in that setting?

[Babycakes1]

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