Short-coupled variant of torsade de pointes

Area of Science:

• Cardiology
• Electrophysiology

Background:

• Primary sclerosing cholangitis and epilepsy are significant comorbidities.
• Cholangitis precipitated a critical cardiac event.

Purpose of the Study:

• To report a rare case of short-coupled Torsade de Pointes (TdP).
• To discuss management strategies for this specific arrhythmia.

Main Methods:

• Electrocardiogram (ECG) monitoring to identify ventricular premature beats (VPBs) and TdP.
• Pharmacological intervention with Verapamil.
• Assessment of arrhythmia suppression and sudden death risk.

Main Results:

• Frequent Torsade de Pointes (TdP) occurred, necessitating 12 defibrillations.
• Verapamil effectively suppressed the ventricular arrhythmia.
• Sudden death risk remained elevated despite Verapamil therapy.

Conclusions:

• Short-coupled TdP is a rare variant of polymorphic ventricular tachycardia with an unclear cause.
• Verapamil can suppress TdP but does not mitigate the risk of sudden cardiac death.
• Implantable cardioverter-defibrillator (ICD) implantation is advised for patients with short-coupled TdP.