[Recurrent torsades and asystole without structural heart disease]
Eva Kathrin Lamadé1,2, Ralf Zahn3, Thomas Kleemann3
1Herzzentrum Ludwigshafen, Bremserstraße 79, 67063, Ludwigshafen, Deutschland. Eva.Lamade@zi-mannheim.de.
Herzschrittmachertherapie & Elektrophysiologie
|July 19, 2021
Summary
A patient experienced recurrent syncope and ventricular tachycardia. A rare cause was identified and treated, improving outcomes despite initial device therapy challenges.
Area of Science:
- Cardiology
- Electrophysiology
- Genetics
Background:
- Recurrent syncope and polymorphic ventricular tachycardia (PVT) in patients without structural heart disease pose diagnostic and therapeutic challenges.
- Standard treatments like implantable cardioverter-defibrillators (ICDs), beta-blockers, and flecainide may not always prevent adverse events.
Observation:
- A 67-year-old female presented with recurrent syncope attributed to asystole and PVT, despite no significant structural heart disease.
- Following ICD implantation and medical therapy, she continued to experience syncope and ICD shocks due to ventricular fibrillation.
Findings:
- A rare genetic cause of polymorphic ventricular tachycardia was identified as the underlying etiology.
- Successful treatment targeted this specific rare condition, resolving the patient's symptoms.
Implications:
- Highlights the importance of investigating rare genetic causes for ventricular arrhythmias in patients presenting without structural heart disease.
- Suggests that tailored genetic therapies may offer superior outcomes compared to conventional management in select cases.
- Emphasizes the need for comprehensive diagnostic approaches beyond standard cardiac evaluations for unexplained syncope and arrhythmias.
Keywords:
AsystoleCoronary spasmIdiopathic ventricular fibrillationRecurrent syncopeVariant anginaVentricular tachyarrhythmiaMore Related Videos
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