title: Torsade de pointes with short coupling interval.
abstract: Torsade de pointes (TdP), a ventricular tachycardia (VT) with the peaks of QRS complexes twisting around the iso-electric baseline and progressive amplitude and polarity variations, is mostly associated with long (congenital or acquired) QT syndromes (LQTS) and long coupling intervals of the initiating complex. We describe a patient with variant, short-coupled TdP, a normal QTc interval and without demonstrable structural heart disease. Mechanisms remain unclear but there may be a relationship with autonomic nervous system imbalance. Since anti-arrhythmic drug efficacy is uncertain, ICD-implantation seems the first-line therapy. If ventricular arrhythmia recurs despite drug therapy, catheter-ablation of initiating premature ventricular beats may be warranted.
authors.affiliation: Dept. of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands. b.van.den.branden@antoniusziekenhuis.nl
authors.forename: Ben
authors.initials: B
authors.lastname: Van den Branden
authors.forename: Eric
authors.initials: E
authors.lastname: Wever
authors.forename: Lucas
authors.initials: L
authors.lastname: Boersma
mesh_terms: D017147:Defibrillators, Implantable; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D016171:Torsades de Pointes / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D018879:Ventricular Premature Complexes / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy