A 25-year control of idiopathic ventricular fibrillation with electrophysiologic-guided antiarrhythmic drug therapy.

The case of a 28-year-old man with recurrent syncope and multiple documented episodes of idiopathic ventricular fibrillation is reported. Recurrent syncope suggesting a self-terminating ventricular tachyarrhythmia occurred after 1 month of amiodarone therapy, and ventricular fibrillation was inducible at electrophysiologic study. After addition of quinidine, no significant ventricular arrhythmias could be induced. Similar results were found during a repeat electrophysiologic study performed 23.5 years later. During a 25-year period, the patient has remained arrhythmia-free on combined antiarrhythmic medication with quinidine and amiodarone.