Fibrillazione ventricolare recidivante nell'infarto miocardico acuto trattata con successo mediante angioplastica coronarica: un caso clinico a favore dell'ipotesi di aritmogenicità del trombo coronarico?

We describe a patient with acute myocardial infarction due to thrombotic occlusion of the left anterior descending coronary artery. Following thrombolytic therapy, five episodes of ventricular fibrillation recurred despite the absence of profibrillatory factors other than myocardial ischemia. Because of thrombolysis failure, rescue angioplasty associated with coronary stent implantation was performed. After successful mechanical artery recanalization, no recurrences of the malignant arrhythmia were observed. This case supports the concept, recently demonstrated in animals, that the process of intracoronary thrombosis itself may have arrhythmogenic effects above and beyond the impact of myocardial ischemia induced by coronary occlusion per se.