A Rare Cause of Ventricular Fibrillation Confirmed by Speckle-Tracking Imaging

Abstract

Abstract Introduction: Cardiac arrhythmias caused by electrical injuries are rare among emergency service admittances. We present a case of ventricular fibrillation (VF) with a rare etiology, confirmed by speckle-tracking imaging. Case presentation: A 38-year-old man was addressed to our hospital to evaluate the etiology of an episode of VF, promptly resuscitated in a territorial hospital. On admission, his 12-lead electrocardiogram revealed a sinus rhythm, without any ST-T changes or atrioventricular conduction disorders. Transthoracic echocardiography and coronary angiography were normal, and the electrophysiological study did not induce VF. Anamnesis showed that the arrhythmia occurred after an electrical injury, resulting from the contact with a domestic low-voltage source. Speckle-tracking imaging revealed closure of the electric arc within the heart, which could explain the absence of skin-burn injuries in this case. The patient was discharged after seven days of hospitalization, without any complication. Conclusions: VF can occur after an unexpected electrical shock during a household accident. This case report underlines the need for a complex interdisciplinary approach in such difficult cases, when the absence of any electrical injuries on the skin makes it difficult to recognize the electrical shock that triggered the ventricular fibrillation.