Interruption of recurrent ventricular fibrillation by psychiatric intervention.

A 32-year-old man with a recent myocardial infarction had recurrent episodes of cardiac arrest that resisted medical management until he was interviewed by a psychiatrist. During the interview he shared his terror and associated to an episode during adolescence when he stole a car and was shot in the chest. After the interview he slept for the first time in three days, and subsequently had no further incidence of cardiac arrest. The case illustrates the potentially life-saving role of psychiatric intervention in reducing sympathetic tone in patients with cardiac instability.