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From the 1/14/2022 release of VAERS data:

This is VAERS ID 261665

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Case Details

VAERS ID: 261665 (history)  
Form: Version 1.0  
Age: 71.0  
Sex: Male  
Location: Michigan  
   Days after vaccination:16
Submitted: 2006-08-14
   Days after onset:18
Entered: 2006-08-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Dyspnoea, Heart rate increased, Nervousness, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zetia
Current Illness:
Preexisting Conditions: Hypercholesterolaemia, Joint disorder
Diagnostic Lab Data: Electrocardiogram 7/27/06 HR 110-120
CDC Split Type: WAES0608USA01046

Write-up: Information has been received from a 71 year old retired physician with no known allergies and hypercholesterolaemia who on 7/11/06 was vaccinated in the left arm with a dose of varicella zoster virus vaccine live. Concomitant therapy included ezetimibe. A couple weeks after vaccination on 7/27/06, the pt experienced tachycardia that was persisted. He was seen by a two cardiologists and had an echocardiogram done which did not show anything. Two EKGs were done and his HR was 110-120. He also reported that he was having a little shortness of breath occasionally,but didn''t think, it was related to vaccination. He did not have any other cardiovascular problems. The physician reported his sustained tachycardia to be potentially life threatening and disabling because he wasn''t sure if his tachycardia was self limiting and temporary or would cause additional problems. He reported that he was nervous when his HR was high for 2-3 weeks. His cardiologist recommended unspecified medication, however the physician refused to take any medication. As of 8/10/06 the physician reported that his heartrate was gradually slowing down, it was 90-100 which was better than before but still not back to normal. Four months prior to vaccination the pt scheduled knee surgery for 8/22/06. He explained that he would proceed with the surgery as long as his heart rate was back to normal. Additional information has been requested.

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