A 24-year-old male with malignant early repolarization syndrome complicated by recurrent ventricular fibrillation and ARDS was managed with quinidine, isoproterenol, and S-ICD placement.
Case Report (n=1)
This case highlights the challenges of managing malignant early repolarization syndrome in the setting of critical illness and the role of triggers like hypoxia and infection in malignant arrhythmias.
Abstract Early repolarization syndrome (ERS), once considered a benign electrocardiographic finding, is now recognized as a potential cause of idiopathic ventricular fibrillation and sudden cardiac death in young adults1,2. We report a case of a previously healthy 24-year-old male who presented with out-of-hospital cardiac arrest due to ventricular fibrillation and subsequently developed acute respiratory distress syndrome (ARDS) secondary to aspiration pneumonia. His hospital course was complicated by recurrent ventricular fibrillation, hypoxemia, electrolyte disturbances, sepsis, and prolonged mechanical ventilation. Coronary angiography and cardiac MRI revealed no structural heart disease. Electrocardiography consistently demonstrated inferolateral J-point elevation consistent with ERS. He was diagnosed with malignant early repolarization syndrome, managed with quinidine and isoproterenol, and underwent subcutaneous implantable cardioverter-defibrillator (S-ICD) placement for secondary prevention. This case emphasizes the challenges of managing ERS in the setting of critical illness and highlights the role of hypoxia, infection, and electrolyte imbalance in triggering malignant arrhythmias. This abstract is funded by: None
S Sah (Fri,) conducted a case report in Early Repolarization Syndrome (n=1). Quinidine, isoproterenol, and S-ICD placement was evaluated. A 24-year-old male with malignant early repolarization syndrome complicated by recurrent ventricular fibrillation and ARDS was managed with quinidine, isoproterenol, and S-ICD placement.