Short-coupled variant of Torsade de Pointes as a cause of electrical storm and aborted sudden cardiac death: insights into mechanism and treatment

Abstract

This case report describes a 50-year-old woman with normal repolarization duration who survived multiple electrical storms and cardiac arrest related to recurrent short-coupled torsade de pointes (TdP). Overdrive ventricular pacing could not prevent malignant TdP, but exposed a pause-related TdP initiation pattern. Isoproterenol and atrial pacing completely suppressed TdP, suggesting that ventricular pacing may entail vulnerability to this condition.