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[Torsades de pointes with short coupling interval]

A Leenhardt1, E Glaser, M Burguera

  • 1Clinique cardiologique, hôpital Lariboisière, Paris.

Archives Des Maladies Du Coeur Et Des Vaisseaux
|May 1, 1993
PubMed
Summary
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This study identifies a new heart rhythm disorder, "torsades de pointes with a short coupling interval," affecting young adults. This ventricular arrhythmia is characterized by a short extrasystole coupling interval and often leads to syncope.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Internal Medicine

Context:

  • Describes a rare ventricular arrhythmia observed in 14 patients and 9 literature cases.
  • Patients presented with syncope linked to torsades de pointes.
  • Characterized by young age (avg. 34.6 years), short coupling interval (avg. 245 ms), and absence of overt cardiac disease.

Purpose:

  • To characterize a distinct clinical and electrocardiographic entity of ventricular arrhythmia.
  • To investigate the underlying electrophysiological and autonomic nervous system factors.
  • To evaluate therapeutic responses and patient outcomes.

Summary:

  • Patients exhibited ventricular extrasystoles with very short coupling intervals, normal resting ECGs, and sometimes a family history of sudden death.

Related Experiment Videos

  • Autonomic nervous system investigations revealed decreased sinus rhythm variability and sympathetic overactivity.
  • Class I antiarrhythmics, beta-blockers, and amiodarone were ineffective; verapamil showed limited benefit.

    • Impact:

    • Suggests a new pathological entity: "torsades de pointes with a short coupling interval."
    • Highlights the unpredictable clinical outcome with current assessment methods.
    • Recommends considering implantable automatic defibrillators for affected patients.