Key result
Targeted pharmacotherapy and an ICD successfully suppress ARDS-triggered recurrent VF in early repolarization syndrome.
Why the study?
Early repolarization syndrome is an important cause of idiopathic ventricular fibrillation in structurally normal hearts and may be exacerbated by systemic stressors such as acute respiratory distress syndrome.
Case Report (n=1)
Systemic stressors like acute respiratory distress syndrome can unmask malignant early repolarization syndrome, which can be successfully managed with targeted antiarrhythmic therapy and ICD placement.
BACKGROUND: Early repolarization syndrome (ERS) is an important cause of idiopathic ventricular fibrillation (VF) in structurally normal hearts and may be exacerbated by systemic stressors. CASE SUMMARY: A previously healthy 24-year-old man presented with out-of-hospital VF arrest. Coronary angiography and cardiac magnetic resonance imaging showed no structural disease. His course was complicated by aspiration pneumonia and acute respiratory distress syndrome. He developed recurrent VF triggered by short-coupled premature ventricular complexes during hypoxemia and hypokalemia. An electrocardiogram demonstrated inferolateral J-point elevation >0.2 mV. Quinidine and isoproterenol suppressed further arrhythmias, and a subcutaneous implantable cardioverter-defibrillator was placed for secondary prevention. He remained arrhythmia-free at follow-up. DISCUSSION: ERS-related repolarization heterogeneity predisposes to VF. Acute respiratory distress syndrome and associated metabolic stress may amplify this arrhythmogenic substrate. TAKE-HOME MESSAGES: ERS should be considered in young patients with unexplained VF. Recognition of triggers, targeted therapy, and implantable cardioverter-defibrillator placement are essential.
No takes yet. Share an insight, caveat, or question.
Sah et al. (2026) conducted a case report in Early repolarization syndrome and ventricular fibrillation (n=1). Quinidine, isoproterenol, and subcutaneous implantable cardioverter-defibrillator was evaluated. A 24-year-old man with early repolarization syndrome developed recurrent ventricular fibrillation triggered by acute respiratory distress syndrome, which was suppressed with targeted pharmacotherapy and an ICD.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: