Treatment of torsades de pointes with esophageal atrial pacing

A 65-year-old woman presented with new onset atrial fibrillation. Medical therapy with digoxin and quinidine was not effective in controlling the arrhythmia. Subsequently, complications developed including a stroke and torsades de pointes. The arrhythmia was successfully controlled by overdrive suppression by esophageal pacing. This case illustrates the usefulness of esophageal pacing and how it may be applied in emergencies when transvenous pacing cannot be readily performed outside the intensive care unit setting.