Ventricular fibrillation in a patient with the permanent form of junctional reciprocating tachycardia

: A case of a 20 year old young man having the permanent form of junctional reciprocating tachycardia complicated by ventricular fibrillation (VF) is reported. A number of antiarrhythmic drugs either as single or combined therapy fail to control tachycardia. Paroxisms of a faster palpitation which never lasted longer than a few minutes were felt over the last six months before the occurrence of VF. At admission, a narrow QRS tachycardia 250 beats/min was recorded and soon degenerated into VF. After electrical shock with 350J permanent form of junctional tachycardia resumed. Electrophysiologic evaluation identified an accessory pathway with long conducting times in postero-septal location, enhanced atrioventricular node conduction and inducible atrial flutter. The patient underwent successful radiofrequency ablation and is doing well after 18 months of follow-up, being off antiarrhythmic drug and tachycardia free.