A case of short-coupled premature ventricular beat-induced ventricular fibrillation with early repolarization in the inferolateral leads

Abstract

This case report describes a 19-year-old man with early repolarization (ER) in the inferolateral leads and a normal QT interval who survived a cardiac arrest that was likely related to polymorphic ventricular tachycardia (VT). Electrocardiograms (ECGs) also showed unifocal premature ventricular beats (PVBs) with a relatively narrow QRS duration. A Holter ECG documented occasional short-coupled PVBs following non-sustained VTs. Pharmacological stress testing was also performed to assess the effects of anti-arrhythmic drugs on ER (the J wave) and PVBs. We performed successful radiofrequency catheter ablation to prevent the recurrence of ventricular fibrillation after cardioverter-defibrillator implantation.

Keywords

• Premature ventricular beat
• Early repolarization
• Short-coupled variant of torsades de pointes
• Radiofrequency catheter ablation
• Implantable cardioverter-defibrillator