Hypothermia can induce the occurrence of ventricular fibrillation in patients with early repolarization syndrome. Osborne waves, also known as J waves, appear as a sawtooth wave following the QRS wave group and in the same direction as the R wave. The J wave was first discovered by Osborne et al in the swine hypothermia model, and later gradually recognized that the J wave is associated with early repolarization syndrome (ERS) and Brugada syndrome. Intracranial hemorrhage can cause damage to the hypothalamus, lead to central temperature regulation disorders, and cause spontaneous hypothermia. Recent clinical studies have shown that environmental factors are significantly related to the onset of events related to ERS and Brugada syndrome, and hypothermia plays an important role. Recently, Rederman NJ et al reported a case of hypothermia-induced ventricular fibrillation in a patient with early repolarization syndrome. This patient is a 34-year-old male patient who mainly presented with ventricular fibrillation attacks while resting at home; the patient had a subarachnoid hemorrhage due to rupture of the anterior communicating artery aneurysm and damaged the hypothalamus before 9 months. The patient had no history of arrhythmia or syncope before intracranial hemorrhage. The patient's ECG monitoring record was ventricular fibrillation when he was admitted to the hospital, and he was converted to sinus rhythm after one electrical cardioversion. The patient's body temperature at that time was 32 ° C. Subsinus rhythm electrocardiogram showed the formation of J waves in the inferior and lateral walls. The QTc interval was 370ms. The QTc interval was prolonged to 420ms after using procainamide. Examination showed no obvious abnormalities, and the related genes of long QT syndrome were negatively monitored. Based on this, the patient was diagnosed with ventricular fibrillation induced by early repolarization syndrome. The patient underwent ICD implantation. After 3 months of surgery, the patient's body temperature dropped to 35 ° C again, and there were 3 episodes of ventricular fibrillation, all of which were successfully discharged. Subsequently, oral amiodarone was added, and there was no ventricular rhythm after long-term follow-up Abnormal attack. The conclusions drawn in this case are as follows: Hypothermia is an important cause of ventricular fibrillation in patients with early repolarization syndrome, and it is highly valued in clinical work.
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