title: Torsades de pointes as a cause of sudden death in a patient with aortic stenosis and atrial fibrillation.
abstract: The occurrence of sudden cardiac death during Holter monitoring in patients with aortic stenosis has been reported previously. In the majority of the reported cases, the cause of death was a malignant ventricular tachyarrhythmia. The presence of a strong association between frequency and complexity of ventricular arrhythmias and sudden death in patients with aortic stenosis has been proposed. We report the case of a 77-year-old woman with aortic stenosis and atrial fibrillation who had an episode of torsades de pointes that degenerated into ventricular fibrillation during Holter monitoring. A short-long-short sequence, but not increased ventricular ectopics, precipitated torsades de pointes and sudden death in this case which is strongly indicative of triggered activity as the underlying mechanism of the lethal arrhythmia.
authors.affiliation: 1st Department of Cardiology, University of Athens Medical School, Athens, Greece. hrodil@yahoo.com
authors.forename: Polychronis
authors.initials: P
authors.lastname: Dilaveris
authors.forename: Charalambos
authors.initials: C
authors.lastname: Vassilopoulos
authors.forename: Evaggelia
authors.initials: E
authors.lastname: Tsagga
authors.forename: Manolis
authors.initials: M
authors.lastname: Vavuranakis
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000150:complications; D001281:Atrial Fibrillation / Q000150:complications; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D016171:Torsades de Pointes / Q000150:complications*