title: Arrhythmic storm: Short-coupled variant torsade de pointes.
abstract: A 49-year-old woman, with no relevant family history, was admitted in 1996 for arrhythmic storm with polymorphic ventricular tachycardia (torsade de pointes) which degenerated into ventricular fibrillation. Iatrogenic causes were excluded, the electrocardiogram (ECG) was normal and there was no structural heart disease. She refused cardioverter-defibrillator implantation. Treatment was begun with amiodarone, which she took irregularly. She remained asymptomatic until 2014 when she was admitted for a new arrhythmic storm with torsade de pointes, refractory to antiarrhythmic therapy and aggravated by ventricular pacing (65 defibrillations). She had frequent ventricular extrasystoles (with short-coupled period <300 ms) preceding the tachycardia. After administration of isoprenaline infusion electric stability was maintained. In this setting and in the absence of structural heart disease or iatrogenic cause, a diagnosis of short-coupled variant torsade de pointes was established. A cardioverter-defibrillator was implanted and she was treated with verapamil, without recurrence of arrhythmias.
authors.affiliation: Serviço de Cardiologia, Hospital de São João, Porto, Portugal. Electronic address: rita_biscaia_godinho@hotmail.com.
authors.forename: Ana Rita
authors.initials: AR
authors.lastname: Godinho
authors.affiliation: Serviço de Cardiologia, Hospital de São João, Porto, Portugal.
authors.forename: Cecília
authors.initials: C
authors.lastname: Frutuoso
authors.affiliation: Serviço de Cardiologia, Hospital de São João, Porto, Portugal.
authors.forename: Mariana
authors.initials: M
authors.lastname: Vasconcelos
authors.affiliation: Serviço de Cardiologia, Hospital de São João, Porto, Portugal.
authors.forename: Paula
authors.initials: P
authors.lastname: Dias
authors.affiliation: Serviço de Cardiologia, Hospital de São João, Porto, Portugal.
authors.forename: Raquel
authors.initials: R
authors.lastname: Garcia
authors.affiliation: Serviço de Cardiologia, Hospital de São João, Porto, Portugal.
authors.forename: Teresa
authors.initials: T
authors.lastname: Pinho
authors.affiliation: Serviço de Cardiologia, Hospital de São João, Porto, Portugal.
authors.forename: Vítor
authors.initials: V
authors.lastname: Araújo
authors.affiliation: Serviço de Cardiologia, Hospital de São João, Porto, Portugal.
authors.forename: Maria Júlia
authors.initials: MJ
authors.lastname: Maciel
mesh_terms: D000889:Anti-Arrhythmia Agents; D001145:Arrhythmias, Cardiac / Q000188:drug therapy; D004562:Electrocardiography; D005260:Female; D006801:Humans; D016171:Torsades de Pointes / Q000175:diagnosis*; D014693:Ventricular Fibrillation / Q000175:diagnosis*
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: Morte súbita cardíaca; Polymorphic ventricular tachycardia; Short-coupled variant torsade de pointes; Sudden cardiac death; Taquicardia ventricular polimórfica; Variante torsade de pointes de acoplamento curto