Sixty-six episodes of ventricular fibrillation within four hours: electrical stability restored by propafenone.

Ventricular fibrillation is a complication in patients hospitalized for acute myocardial infarction. We report the case of an unusually high number of episodes of ventricular fibrillation (66 episodes) that occurred within a period of 4 h in a patient with recent anterior myocardial infarction. In patients with acute or recent myocardial infarction and recurrent episodes of ventricular fibrillation, intravenous lidocaine is the antiarrhythmic medication of choice. In our patient, recurrences of ventricular fibrillation were not prevented either by lidocaine, or amiodarone. The rate of recurrence of ventricular fibrillation, however, decreased dramatically, twice, in the minutes following two separate boluses of propafenone, and the arrhythmia did not recur when continuous infusion of propafenone was started. We cannot exclude that were the combined antiarrhythmic effects of lidocaine, amiodarone and propafenone that led to the final control of the arrhythmia.