Spontaneous conversion of ventricular fibrillation in cardiogenic shock from acute myocardial infarction

Spontaneous termination of sustained periods of ventricular fibrillation (VF) are rare, particularly in persons in low cardiac output states. Many reports of paroxysmal VF likely represent examples of polymorphic, nonsustained ventricular tachycardia (VT) or torsades de pointes. We recently observed a patient receiving high-dose dopamine for hemodynamic support in whom VF developed in the absence of prior QT prolongation, which spontaneously reverted to sinus rhythm without pharmacologic or electrical intervention.