Ventricular fibrillation usually is sustained and unrelenting in human subjects and rarely is self-terminating after 30 seconds' duration. Temporal evolution of the arrhythmia in our patient suggested that organization of electrical activity varies over time. Interaction of organization with high catecholamine levels and hyperkalemia may play a role in self-termination of ventricular fibrillation. Understanding the true mechanisms of spontaneous defibrillation may provide newer therapeutic options for treatment of this otherwise fatal arrhythmia.