A 50-year-old man with idiopathic ventricular fibrillation experienced recurrent sustained ventricular tachycardia that was successfully terminated by an implantable cardioverter-defibrillator.
Case Report (n=1)
Idiopathic ventricular fibrillation can present as sudden cardiac arrest despite reassuring preoperative cardiovascular evaluation, and survivors remain at high risk for recurrent arrhythmias requiring ICD therapy.
BACKGROUND: Idiopathic ventricular fibrillation is characterized by malignant ventricular arrhythmias without identifiable structural heart disease or inherited arrhythmia syndrome. CASE SUMMARY: A 50-year-old man suffered out-of-hospital cardiac arrest approximately 1 hour after preoperative cardiovascular clearance for elective surgery. He had no preceding symptoms or known structural heart disease. Immediate bystander cardiopulmonary resuscitation and defibrillation resulted in successful resuscitation. Coronary angiography, cardiac magnetic resonance, electrophysiological study, and genetic testing were unrevealing. A dual-chamber implantable cardioverter-defibrillator was implanted for secondary prevention. Longitudinal device interrogation later demonstrated sustained ventricular tachycardia terminated by antitachycardia pacing. DISCUSSION: This case highlights the limitations of current cardiovascular risk stratification in identifying occult malignant ventricular arrhythmias and reinforces the importance of implantable cardioverter-defibrillator therapy for secondary prevention. TAKE-HOME MESSAGES: Idiopathic ventricular fibrillation may present as sudden cardiac arrest despite unrevealing structural evaluation and apparently reassuring preoperative cardiovascular assessment. Survivors of unexplained ventricular fibrillation remain at substantial risk for recurrent malignant arrhythmias, reinforcing the importance of implantable cardioverter-defibrillator therapy for secondary prevention.
Ganthan et al. (Mon,) conducted a case report in Idiopathic ventricular fibrillation (n=1). Implantable cardioverter-defibrillator was evaluated on Recurrent malignant arrhythmias. A 50-year-old man with idiopathic ventricular fibrillation experienced recurrent sustained ventricular tachycardia that was successfully terminated by an implantable cardioverter-defibrillator.
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