Related Experiment Video

Updated: Aug 3, 2025

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
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Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

Published on: January 31, 2019

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[Sudden cardiac death after cardioversion]

Felix Bertram1, Jochen Buchholz2

  • 1Klinik für Innere Medizin, Evangelisches Krankenhaus Oberhausen (Rheinland), Oberhausen, Deutschland, Virchowstr. 20, 46047 Oberhausen.

Herzschrittmachertherapie & Elektrophysiologie
|April 7, 2023
PubMed

Insights

A patient with heart failure experienced a fatal outcome due to QT interval prolongation and torsade de pointes after cardioversion. Impaired left ventricular function and atrial ectopy were identified as the primary causes.

Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Atrial tachycardia with reduced left ventricular ejection fraction (LVEF) is a significant cause of heart failure.
  • Cardioversion is a common procedure to restore normal heart rhythm.

Observation:

  • An 83-year-old female patient with heart failure presented with atrial tachycardia and reduced LVEF.
  • The patient underwent cardioversion for rhythm restoration.

Findings:

  • Post-cardioversion Holter monitoring revealed massive QT interval prolongation.
  • This prolongation led to torsade de pointes, a life-threatening ventricular arrhythmia.
  • Impaired left ventricular function and atrial ectopy were identified as the sole contributors to QT prolongation.

Implications:

  • This case highlights the critical risk of QT prolongation and torsade de pointes in patients with compromised left ventricular function.
  • Careful electrophysiological assessment and monitoring are crucial before and after cardioversion in such high-risk patients.
  • Understanding the interplay between cardiac function, atrial ectopy, and proarrhythmic events is vital for preventing adverse outcomes.

Keywords:
CardioversionHeart failureQT prolongationTachymyopathyTorsade de pointe

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