Background A 25-year-old woman experienced three episodes of syncope over the course of 2 years. The attacks all occurred just after she had sat down, and two were accompanied by convulsions. She had no obvious prodromes and no personal or family history of cardiovascular disease.
Investigations Electrocardiography, chest radiography, echocardiography, cerebral and cardiac MRI, electroencephalography, 24 h Holter monitoring, electrophysiological study with drug provocation testing and heart-rate variability analysis.
Diagnosis Vagally mediated ventricular fibrillation initiated by premature ventricular complexes arising from the right ventricular outflow tract.
Management Catheter ablation was performed at the right ventricular outflow tract and an implantable cardioverter-defibrillator was fitted.
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The authors would like to thank K Fukumoto for his cooperation in collecting data, and J Annis for his linguistic advice.
The authors declare no competing financial interests.
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Kataoka, M., Takatsuki, S., Tanimoto, K. et al. A case of vagally mediated idiopathic ventricular fibrillation. Nat Rev Cardiol 5, 111–115 (2008). https://doi.org/10.1038/ncpcardio1082
Nature Communications (2017)
Journal of Interventional Cardiac Electrophysiology (2012)