Effective Therapy of Cilostazol in a Patient with Recurrent Ventricular Fibrillation Associated with Early Repolarization Pattern

Background: Efficacy of Quinidine was reported in patients with idiopathic ventricular fibrillation (VF) associated with early repolarization pattern on the electrogram. However, we experienced a case with recurrent VF associated with early repolarization pattern which was refractory to quinidine. Case: A 64-year-old woman was admitted to our hospital. Two years ago, she was diagnosed as idiopathic VF associated with early repolarization pattern and underwent implantable cardioverter-defibrillator (ICD) implantation. During follow-up period, ICD showed multiple VF episodes at early morning. Quinidine and bepridil were initiated but failed to prevent VF attacks. Ventricular pacing also could not suppress VF episodes. We tried cilostazol which was reported as an effective drug to prevent VF in Brugada syndrome. After cilostazol was initiated, no VF episodes were observed during her hospitalization and follow-up of 4 months.This case report demonstrated the efficacy of the cilostazol therapy to eliminate recurrent VF in a patient with early repolarization syndrome like Brugada syndrome.