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Related Experiment Videos

[Torsades de Pointes: a cause of syncope in sinus node dysfunction].

E Velázquez Rodríguez1, J Rangel Rojo, A Ortega Sánchez

  • 1Unidad de Cuidados Intensivos Cardiológicos, Hospital Central Norte de Concentración Nacional PEMEX, Azcapotzalco, México, D.F.

Archivos Del Instituto De Cardiologia De Mexico
|June 12, 1999
PubMed
Summary

Sinus node dysfunction can rarely cause syncope with Torsade de Pointes (TdP). Pacing effectively treated a patient with bradycardia-induced long QT interval and TdP.

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Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Torsade de Pointes (TdP) is a ventricular arrhythmia linked to QT interval prolongation.
  • Bradyarrhythmias, particularly atrioventricular block, are known TdP triggers.
  • Sinus node dysfunction as a cause of syncope with TdP is uncommon.

Observation:

  • This case report details a patient experiencing recurrent syncope.
  • The patient presented with sinus bradycardia and intermittent atrioventricular nodal rhythm.
  • These cardiac conditions induced a prolonged QT interval.

Findings:

  • The prolonged QT interval and TdP were associated with bradycardia and pauses.
  • Experimental data suggests pause-dependent early afterdepolarizations contribute to TdP.
  • The patient's syncope was directly related to Torsade de Pointes episodes.

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Implications:

  • Sinus node dysfunction should be considered in syncope evaluations, especially with QT prolongation.
  • Pacing offers a potential treatment for TdP secondary to bradycardia-induced long QT.
  • Understanding the link between bradycardia and TdP may improve patient management.