title: A case of a short-coupled variant of torsades de Pointes with electrical storm.
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.
authors.affiliation: First Dept. of Internal Medicine, Asahikawa Medical College, Midorigaoka Higashi 2-1-1-1, Asahikawa, 078-8510, Japan. take21@asahikawa-med.ac.jp
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sato
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Kawamura
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Takahashi
authors.forename: Motohiko
authors.initials: M
authors.lastname: Sato
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kikuchi
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Akasaka
authors.forename: Kazutomo
authors.initials: K
authors.lastname: Go
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Hasebe
mesh_terms: 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
chemical_list: D008801:Mexiletine; D014700:Verapamil