Evolving J waves Prior to Ventricular Fibrillation Postoperative Coronary Bypass

Hitoshi Kitazawa, Takayuki Wakasugi, Tsutomu Sugimoto, Kazuo Yamamoto, Shinpei Yoshii, Yoshifusa Aizawa
2011 Internal medicine (Tokyo. 1992)  
A 74-year-old man without history of ventricular arrhythmias underwent coronary bypass surgery for 3vessel 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
more » ... eappeared 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.
doi:10.2169/internalmedicine.50.5934 pmid:22001461 fatcat:jn4ofu7flvciphyj2wm4pybqwm