Torsade de pointes in a patient with complete atrioventricular block and pacemaker failure, misdiagnosed with
Si-Yu Cai1, Shen-Feng Ye1, Xiang Wu1
1Department of Cardiology, 2nd Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Abstract:
A case of torsade de pointes (TdP) with complete atrioventricular block and pacemaker failure that was misdiagnosed as epilepsy is presented herein. An 82-year-old female with recurrent seizure-like attacks showed epileptiform discharge during an electroencephalogram recording. A long QT interval and severe hypokalemia induced runs of TdP, which was related to pacemaker lead fracture, was detected during Holter recording and accompanied with episodes of seizures. After a DDD pacemaker with a new ventricular lead was replaced, there was no recurrence of any seizure-like attacks. Bradycardia-mediated TdP associated with complete atrioventricular block should not be missed in patients with recurrent seizure-like attacks even after pacemaker implantation.
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