Painless myocardial ischemia as a risk factor of constantly relapsing paroxysms of cardiac fibrillation

: A case is reported illustrating relationship between marked coronary atherosclerosis with development of painless myocardial ischemia (PMI) and constantly recurrent paroxysms of cardiac fibrillation (CF). A male 62-year-old patient suffering from paroxysmal CF received cordaron in a dose 200 mg twice a day. The treatment was ineffective until a comprehensive examination (thyroid hormones, echocardiography, Holter ECG monitoring, treadmill test, CT of the coronary arteries) found PMI episodes and severe stenosing atherosclerosis and the treatment was changed for sotalex (80 mg twice a day). Sotalex treatment was effective and stopped recurrences of CF.