Short coupled torsade de pointes: Critical timing of the ventricular premature beats

• Published in: Journal of electrocardiology Vol. 65; pp. 69 - 72
• Main Authors: Guillen, Raul Horacio, Chort, Camila, Mantilla, Luis, Sriram, Chenni S., Gonzalez, Mario D.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2021; Elsevier Science Ltd
• Subjects: Cardiac arrhythmia; Cardiovascular disease; Electrocardiography; Heart failure; Older people; Short coupled premature ventricular complexes; Torsade de pointes (TdP); Verapamil electrical storm; Verapamil electrical storm; Short coupled premature ventricular complexes; Torsade de pointes (TdP)
• ISSN: 0022-0736; 1532-8430
• DOI: 10.1016/j.jelectrocard.2021.01.006

In this case report, we describe a 73 year old female with structuraly normal heart that developed shortcoupled torsades de pointes (TdP) resulting in an electrical storm unresponsible to several antiarrhythmic drugs, but fully controlled with verapamil. The critical timing of the ventricular premature beats that initiated TdP corresponded to those that occurred at the peak of the previous T wave. This behavior differentiates this entity from other forms of malignant ventricular arrhythmias in patients with structurally normal heart. It is imperative that the clinical set-up and unique electrocardiographic fingerprint of this unusual malignant entity be assiduously recognized since verapamil can be life-saving in this condition.