Case report: A 19-year-old female presented with an out of hospital cardiac arrest caused by ventricular fibrillation (VF) after alcohol intake and immersion into water. After defibrillation, sinus rhythm appeared with pre-excitation in accordance with a right sided postero-septal accessory pathway. Twenty-four hours after therapeutic hypothermia she regained consciousness without neurological injury. The patient had no cardiac history. The accessory pathway was successfully ablated. Cardiac imaging demonstrated isolated non-compaction cardiomyopathy of the left ventricular myocardium (INVM).
Sofar, an accessory pathway has only been described in 2 adult and 4 paediatric INVM patients. However, an adolescent patient with a Wolff-Parkinson-White syndrome and INVM presenting with VF has never been described before.
Based on clinical data, it is impossible to determine whether VF was the result of either INVM or atrial fibrillation with fast conduction over the accessory pathway. She received a subcutaneous ICD for secondary prevention.
Conclusions: In conclusion, we described a 19-year-old patient who presented with an out of hospital cardiac arrest due to VF in the presence of a right sided postero-septal located accessory pathway. Surprisingly, we also found an INVM.