[SCD-FORUM] 81C Case: Male, 29yrs. Dr. Zhu

[SCD Symposium]

Case: Male, 29yrs

Illness history: Viral myocarditis was diagnosed based on premature  
ventricular contractions (PVCs) at age 8 after an influenza attack.  
Since then, PVBs never disappeared and right ventricle enlargement  
had been noticed.

ECG revealed VT lasting 3 minutes at age 19, accompanied with  
faintness. After 2-3 years, no VT reoccurred.

The second VT episode was recorded at age 21 lasting 2-3 hrs  
accompanied with syncope. Intravenous propafenon worked. Oral  
administration of propafenon could not prevent the patient from VT  
attack.

RFCA for VT had been delivered twice at age 22~23 by Pro. Yang at the  
first affiliated Hospital of Dalian medical university. During RFCA,  
VT could not be induced and cardiomyopathy was diagnosed by  
endocardiac biopsy.


VTs occurred intermediately lasting several seconds to a few minutes.  
VT restored to sinuous rhythm either spontaneously or by intravenous  
propafenon administration. VT usually occurred at midnight or early  
morning. At the following years, Sometimes VT occurred quite often  
during a certain period (for example: twice attacks in Winter), and  
then no occurrence for several months or even longer time. The  
patient enjoys doing exercise. No VT attacked during exercise. No  
restriction to exercise.

Since 27 yrs old (2004), propafenon has been administrated in the  
doses of 150mg bid or tid. Drug quitted after 1-2 months  
administrations, keeping no VT attack for 0.5-1.5 yrs.
Since last year, the drug cannot be quitted, otherwise VT reoccurred.  
So far, the doses of the drug are 200mg at early morning and 150mg at  
night. Lower dosages may not prevent the VTs.

Any suggestion about the treatment?

Zhu <dyeyxnk at yahoo.com.cn>

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee




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