Arrhythmic storm: Short-coupled variant torsade de pointes

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• 作者：Ana Rita Godinho ; ^{rita_biscaia_godinho@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Cecí ; lia Frutuoso ; Mariana Vasconcelos ; Paula Dias ; Raquel Garcia ; Teresa Pinho ; Ví ; tor Araú ; jo ; Maria Jú ; lia Maciel
• 关键词：Polymorphic ventricular tachycardia ; Sudden cardiac death ; Short-coupled variant torsade de pointes
• 刊名：Revista Portuguesa de Cardiologia (English Edition)
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：35
• 期：5
• 页码：307.e1-307.e5
• 全文大小：1981 K

文摘

A 49-year-old woman, with no relevant family history, was admitted in 1996 for arrhythmic storm with polymorphic ventricular tachycardia (torsade de pointes) which degenerated into ventricular fibrillation. Iatrogenic causes were excluded, the electrocardiogram (ECG) was normal and there was no structural heart disease. She refused cardioverter-defibrillator implantation. Treatment was begun with amiodarone, which she took irregularly.

She remained asymptomatic until 2014 when she was admitted for a new arrhythmic storm with torsade de pointes, refractory to antiarrhythmic therapy and aggravated by ventricular pacing (65 defibrillations). She had frequent ventricular extrasystoles (with short-coupled period <300 ms) preceding the tachycardia. After administration of isoprenaline infusion electric stability was maintained. In this setting and in the absence of structural heart disease or iatrogenic cause, a diagnosis of short-coupled variant torsade de pointes was established. A cardioverter-defibrillator was implanted and she was treated with verapamil, without recurrence of arrhythmias.