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KMID : 1011920090100010027
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International Journal of Arrhythmia
2009 Volume.10 No. 1 p.27 ~ p.28
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Pak Hui-Nam
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Abstract
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We experienced a 72-year-old female patient who experienced bradycardia dependent torsade de pointes. The patient came to emergency room due to recurrent syncope in recent 2 weeks. Initial electrocardiogram (ECG) showed complete atrioventricular block with frequent premature ventricular contractions (PVCs). However, non-sustained polymorphic ventricular tachycardias (VTs) were observed in ECG from time to time with long-short-long QRS sequence. This type of polymorphic VT was induced by ion channel remodeling based on bradycardia. Because HIS bundle electrogram showed infra-HISian block, we implanted DDD type pacemaker. Even though the patient experienced syncope due to polymorphic VT, implantable cardioverter defibrillator (ICD) is not necessary except for the primary prevention purpose in patients with heart failure.
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KEYWORD
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torsade de pointes, bradycardia dependent, pacemaker
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