[Torsade de pointes--a cause of Morgagni-Adam-Stokes attacks in patients with complete atrioventricular block].
BACKGROUND
Atrioventricular block may occasionally be complicated by Torsades de Pointes inducing Morgagni-Adam-Stokes attacks. The aim of our study was to evaluate the factors of increased risk of Torsade de Pointes during atrioventricular block.


METHODS
We reviewed the records of 7 hospitalized patients who developed Morgagni-Adam-Stokes attack due to Torsades de Pointes resulting from atrioventricular block, while waiting for permanent pacemaker implantation. None of the patients were on antiarrhythmic drugs and no electrolyte abnormalities were present.


RESULTS
There were 6 women and 1 man, mean age was 75 +/- 3 years. All episodes of Torsades de Pointes resulted in patients loss of consciousness and required electrical cardioversion. The mean QT and QTc intervals were 28 +/- 608 ms and 47 +/- 506 ms. respectively. The mean ventricular cycle length during atrioventricular block was 156 +/- 1476 ms. While monitoring, patients premature ventricular beats were found in 6 patients before the onset of Torsades de Pointes.


CONCLUSIONS
Although patients with atrioventricular block may be asymptomatic or mildly symptomatic our findings suggest that Torsades de Pointes and sudden cardiac death may occur, particularly in women with QT interval longer than 600 ms and the presence of premature ventricular beats.
Antonelli
Dante
D
Department of Cardiology, Ha'Emek Medical Center, Afula, Israel. antonelli_dante@hotmail.com
Rozner
Ehud
E
Freedberg
Nachum Adam
NA
Turgeman
Yoav
Y
D000368:Aged; D000369:Aged, 80 and over; D054537:Atrioventricular Block / Q000150:complications*; D005260:Female; D006801:Humans; D008133:Long QT Syndrome / Q000209:etiology*; D008297:Male; D016171:Torsades de Pointes / Q000150:complications*