Fever as a precipitant of idiopathic ventricular fibrillation in patients with normal hearts

Jean Luc Pasquié, Prashanthan Sanders, Mélèze Hocini, Li Fern Hsu, Christophe Scavée, Pierre Jais, Yoshihide Takahashi, Martin Rotter, Fréderic Sacher, Jacques Victor, Jacques Clémenty, Michel Haïssaguerre

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47 Citations (Scopus)


Fever and Idiopathic VF. Introduction: Ventricular fibrillation (VF) is the main mechanism of sudden cardiac death. The clinical precipitants of sudden cardiac death due to idiopathic VF are poorly characterized. Emerging evidence implicates triggers originating predominantly from the distal Purkinje arborization and the right ventricular outflow tract. Methods and Results: We report three patients without structural heart disease or repolarization abnormalities in whom a febrile illness was the only concurrent disease associated with unexpected sudden cardiac death due to VF storm. An automated defibrillator was implanted in all three patients. In one patient with persistent recurrent VF episodes, mapping demonstrated the origin of these triggers was from the Purkinje arborization of the anterior wall of the right ventricle. Ablation at a site of earliest activation during ectopy, where pace mapping was concordant and Purkinje potential preceded the onset of ventriculogram, resulted in suppression of all arrhythmias. After follow-up of 22, 9, and 18 months in the three patients, no ventricular arrhythmias have been recorded. Conclusion: We present a series of patients in whom an apparently benign febrile illness was associated with malignant ventricular arrhythmias in the absence of cardiac disease or other factors known to precipitate sudden cardiac death. Physicians should be aware of this possible phenomenon in cases of febrile illness associated with syncope.

Original languageEnglish
Pages (from-to)1271-1276
Number of pages6
JournalJournal of Cardiovascular Electrophysiology
Issue number11
Publication statusPublished or Issued - Nov 2004


  • Fever
  • Sudden death
  • Syncope
  • Ventricular ectopy
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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