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From the 6/11/2021 release of VAERS data:

This is VAERS ID 904498



Case Details

VAERS ID: 904498 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2020-12-18
Onset:2020-12-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardioversion, Ventricular tachycardia
SMQs:, Torsade de pointes/QT prolongation (narrow), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin Levothyroxine Fenofibrate Fish oil Aspirin Losartan Lantus Trulicity
Current Illness: Covid-19 in November
Preexisting Conditions: Tetralogy of Fallot Defibrillator Artificial pulmonary valve Diabetes Hypertriglyceridemia
Allergies: NKDA
Diagnostic Lab Data: Interrogation of defibrillator showing VT at 230bpm
CDC Split Type: vsafe

Write-up: Ventricular tachycardia. Defibrillator paced me out of rhythm. I have had my ICD for 3 years. This is the first abnormal rhythm I have had where it delivered a therapy to abort it.


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