Abbreviations
ICD
implantable cardioverter defibrillator
LVNC
left ventricular noncompaction
We report the case of a 33-month-old boy, who was referred to our emergency care unit because he presented with syncope during effort. There was no family history of sudden cardiac death. Initial clinical examination and electrocardiogram were strictly normal. After a sudden cardiac arrest due to ventricular fibrillation in the emergency room, he was defibrillated. Subsequently, the patient was shocked several times due to repeated episodes of ventricular fibrillation. Two-dimensional echocardiography established the diagnosis of isolated LVNC ( Fig. 1 ). A few days after the cardiac arrests occurred, left ventricular function was normal. An automatic ICD (Virtuoso II VR; Medtronic, Inc., Minneapolis, MN, USA) was implanted in the chest of this 15 kg child ( Fig. 2 ). A sternotomy was performed to facilitate epicardial placement of the shocking leads. The ICD generator was placed into the abdomen. Antiarrhythmic drug therapy (amiodarone) was started immediately after the cardiac arrests occurred and was continued in association with aspirin at an antiplatelet dose. Six months later, three episodes of ventricular fibrillation were successfully shocked. The ICD did not produce inappropriate shocks and appeared to be well tolerated.
