Ventricular Fibrillation Induced by Spontaneous Hypothermia in a Patient with Early Repolarization Syndrome


  • The study was supported by the Heart and Stroke Foundation of Ontario (T6730). Dr. Krahn is a Career Investigator of the Heart and Stroke Foundation of Ontario (CI6498).

  • No disclosures.

Address for correspondence: Andrew Krahn, M.D., Room 9175, Gordon & Leslie Diamond Health Care Centre, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada. Fax: 604-875-5504; E-mail:

Hypothermia and Early Repolarization Syndrome


The early repolarization (ER) pattern on ECG was originally described in the context of hypothermia.

Case Summary

We present the case of a 34-year-old male with cardiac arrest in the context of spontaneous hypothalamic mediated thermal dysregulation after intracranial hemorrhage. Ventricular fibrillation with a marked ER pattern recurred with therapeutic hypothermia. Spontaneous hypothermia due to hypothalamic dysregulation was observed to enhance the amplitude of the ER pattern and was contemporaneous with recurrent ventricular fibrillation during follow-up.


Hypothermia is an important trigger of VF in the setting of early repolarization syndrome, and warrants assessment as an environmental trigger of spontaneous events. (J Cardiovasc Electrophysiol, Vol. 24, pp. 586–588, May 2013)