[Association of an epsilon wave and syncope].

BACKGROUND: Epsilon waves, rarely observed in clinical practice, result from late potentials favoring the development of ventricular rhythm disorders by reentry.

CASE REPORT: A 53-year-old man with sequellar myocardial infarction experienced a syncope. The surface ECG recorded an epsilon wave. Programmed ventricular stimulation before and after anti-arrhythmia drugs triggered ventricular tachycardia which was hemodynamically poorly tolerated. A defibrillator was implanted and confirmed retrospectively the rhythmic origin of the syncope.

DISCUSSION: The association of an epsilon wave and syncope should guide the etiology search towards severe ventricular rhythm disorders such as ventricular tachycardia. An electophysiologic study is required in order to determine the appropriate therapy and thus help avoid possibly fatal recurrence.