Short-Coupled Premature Ventricular Contractions in a Young Male with Sudden Cardiac Arrest.

Idiopathic ventricular fibrillation secondary to short-coupled premature ventricular contractions (scPVCs) is a rare cause of sudden cardiac arrest and predominantly originates from the His-Purkinje system or right ventricular outflow tract. A 36-year-old man with prior episodes of palpitations and a normal Holter monitor evaluation as well as a family history of sudden cardiac death presented following an out-of-hospital ventricular fibrillation cardiac arrest. After exclusion of other etiologies including structural, ischemic, and primary electrical disease, as well as the demonstration of scPVCs with moderator band origin, a diagnosis of scPVCs leading to sudden cardiac arrest was made. Following implantable cardioverter defibrillator and treatment of other medical concerns, he was discharged home. Idiopathic ventricular fibrillation is an uncommon cause of sudden cardiac arrest. The diagnosis is made after the exclusion of other etiologies and the demonstration of characteristic electrocardiogram findings.

Conclusions: Short-coupled premature ventricular contractions are a rare cause of sudden cardiac arrest.The diagnosis is based on the demonstration of characteristic electrocardiogram findings and the exclusion of other etiologies including structural, ischemic, and primary electrical disease.Treatment involves pharmacotherapy, implantable cardioverter defibrillator placement, and cardiac ablation.