Myocarditis-associated ventricular fibrillation. An unusual cause of syncope in Wolff-Parkinson-White syndrome.

We report the case of a 60-year-old man with long-standing symptomatic Wolff-Parkinson-White syndrome who presented with recurrent syncope and documented spontaneous ventricular fibrillation. This primary ventricular fibrillation, which was not preceded by atrial fibrillation, was associated with lymphocytic myocarditis and not with Wolff-Parkinson-White syndrome. The patient was treated with radiofrequency ablation of the accessory pathway and a drug regimen of prednisone, amiodarone, and metoprolol. At the 6-month follow-up, he was asymptomatic and had returned to work. To our knowledge, the association of acute lymphocytic myocarditis and Wolff-Parkinson-White syndrome has not been previously reported.