A case of a short-coupled variant of torsades de Pointes with electrical storm.
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.
Takeuchi
Toshiharu
T
First Dept. of Internal Medicine, Asahikawa Medical College, Midorigaoka Higashi 2-1-1-1, Asahikawa, 078-8510, Japan. take21@asahikawa-med.ac.jp
Sato
Nobuyuki
N
Kawamura
Yuichiro
Y
Takahashi
Fumihiko
F
Sato
Motohiko
M
Kikuchi
Kenjiro
K
Akasaka
Nobuyuki
N
Go
Kazutomo
K
Fujimoto
Kazuhiro
K
Hasebe
Naoyuki
N
D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D006801:Humans; D008297:Male; D008801:Mexiletine / Q000627:therapeutic use; D008875:Middle Aged; D010138:Pacemaker, Artificial; D013686:Telemetry; D016171:Torsades de Pointes / Q000175:diagnosis / Q000503:physiopathology*; D014693:Ventricular Fibrillation / Q000503:physiopathology; D018879:Ventricular Premature Complexes / Q000503:physiopathology; D014700:Verapamil / Q000627:therapeutic use
D008801:Mexiletine; D014700:Verapamil