Nordkin, I. Rosenfeld, T. Levinas, A. Goldberg, M. Halabi

Cardiolody Department, Ziv Medical Center, Safed, Israel


Introduction: There are few reports of VT related to fever in patients with CVD or channelopathy. We describe an unusual case of recurrent VT triggered by febrile illness, without inducible arrhythmias on EPS while free of fever.
Case presentation: A 28-year-old man with ostium secundum ASD closure in childhood presented with fever, tonsillitis and palpitations. ECG revealed fast VT. He was treated by cardioversion, amiodarone, ?-blockers, and paracetamol. ECG in sinus rhythm and blood tests were normal. Echocardiography revealed normal LV and RV structure and function, and normal valves as well. The first episode of VT was detected 3 years ago during febrile illness. He was converted to NSR with amiodarone. A ?-blocker was recommended on discharge, but was stopped afterwards. Between these two events the patient was asymptomatic.
Conclusions: The patientís episodes of VT associated with fever may be triggered by endogenous pyrogens or altered synthesis of cathecholamines during febrile illness. A ?-blocker could play important role in the prevention and treatment of VT events in this patient.