Abstract
BackgroundWe report a well‐documented case of a patient, a 62‐year‐old man, with severe and asymptomatic left main coronary artery disease who had several episodes of silent myocardial ischemia and a syncopal attack during Holter recording.Methods and ResultsAmbulatory monitoring showed isolated giant U waves separated from the T wave 60 minutes before syncope that was due to reversible ventricular fibrillation lasting about 4 minutes and spontaneously reverting to asystole (7 seconds) and then to atrial fibrillationConclusionOur experience suggests that myocardial ischemia may differently affect the repolarization times within the myocardium leading to widely disparate repolarization gradients that may represent the arrhythmogenic substrate for the occurrence of life‐threatening ventricular tachyarrhythmias. A.N.E. 1999; 4(2):250–254
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