A case of a short-coupled variant of torsades de Pointes with electrical storm

Pacing Clin Electrophysiol. 2003 Feb;26(2 Pt 1):632-6. doi: 10.1046/j.1460-9592.2003.00106.x.

Abstract

This case report describes a short-coupled variant of Torsades de Pointes with a characteristic ECG pattern consisting of a prominent J wave in leads V3-V6, in which an electrical storm was evoked with autonomic receptor stimulation and a blockade test. The patient's frequent VF attacks were triggered by short-coupled premature ventricular contractions with a right bundle branch block morphology and left-axis deviation, and were suppressed by deep sedation followed by a combination therapy using verapamil and mexiletine. Interestingly, with the use of those drugs, the prominent J wave diminished. The mechanism underlying this syndrome is discussed.

Publication types

  • Case Reports

MeSH terms

  • Electrocardiography*
  • Electrophysiologic Techniques, Cardiac
  • Humans
  • Male
  • Mexiletine / therapeutic use
  • Middle Aged
  • Pacemaker, Artificial
  • Telemetry
  • Torsades de Pointes / diagnosis
  • Torsades de Pointes / physiopathology*
  • Ventricular Fibrillation / physiopathology
  • Ventricular Premature Complexes / physiopathology
  • Verapamil / therapeutic use

Substances

  • Mexiletine
  • Verapamil