Abstract
BACKGROUND: Unexpected life-threatening arrhythmias, even when occurring in hospital, are frequently ill documented, hindering a proper understanding of their mechanism. CASE SUMMARY: We present a patient with coronary artery disease who developed an episode of ventricular fibrillation during a cardiovascular magnetic resonance examination. The arrhythmia appeared immediately after the injection of a contrast agent during a quantitative myocardial perfusion sequence at rest, with no stressor agent involved. DISCUSSION: To our knowledge, this is the first episode of ventricular fibrillation documented with simultaneous electrocardiographic, physiological recordings, and quantitative myocardial perfusion data. Such unique information allowed for a comprehensive analysis of the sequence of facts preceding the final arrhythmia and, in consequence, provided a well-reasoned conclusion on its mechanism.