PO-04-053 OUT-OF-HOSPITAL CARDIAC ARREST ASSOCIATED WITH EARLY REPOLARIZATION

Early repolarization syndrome (ERS) is characterized by J-point elevation presenting as slurring or notching of the terminal part QRS complex. Of several congenital and acquired disorders that encompass J-wave syndromes, ERS has been linked to increased risk developing polymorphic VT idiopathic VF can lead sudden cardiac death. To describe a patient who presented after arrest with initial ECG criteria consistent Type III recieved dual-chamber ICD. n/a We present case 42-year-old man without any prior history emergency room successful resuscitation from out-of-hospital due VF. After noticing agonal respiration during early morning hours, his wife called medical services (EMS) promptly performed cardiopulmonary resuscitation. Upon arrival, EMS found be in He was shocked once an automatic external defibrillation leading ROSC restoration sinus rhythm. In ED, vitals were 122/93 mmHg, 104 bpm, 95% oxygen saturation on air, temperature 36.4 °C. denied family Wife reported nocturnal respirations. Initial diagnostic work-up significant for leukocytosis 19,000 serial high-sensitivity troponins 130, 305, 364 0/3-hour delta change 234. A12-lead upon presentation shown Figure 1 previous ECGs available comparison. An emergent coronary angiography which revealed no obstruction anomaly. With both findings Shanghai Score 7, diagnosis highly suspected. Further testing included TTE showing left ventricular dysfunction ejection fraction 40-45%. CMR showed delayed gadolinium enhancement. Ultimately, ICD implanted admission. Follow-up resolution slurred complexes. discharged beta blocker low-dose losartan close outpatient follow-up electrophysiology. changes dynamic may sometimes concealed, particularly setting arrest. It important identify patterns adverse prognostic significance especially associated highest level development malignant arrhythmia.