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"Torsade de pointes" initiated by electrical ventricular stimulation
Journal of Electrocardiology
|January 1, 1976
Summary
Electrical stimulation of the right ventricle can induce torsade de pointes, a dangerous ventricular arrhythmia. This occurs even outside of typical bradycardia contexts, highlighting electrical induction as a potential trigger.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Arrhythmias
Background:
- Torsade de pointes is a specific ventricular arrhythmia typically associated with bradycardia, hypokalemia, and prolonged QT interval.
- It is often initiated by late-occurring ventricular extrasystoles during repolarization.
Observation:
- Electrical stimulation of the right ventricle induced torsade de pointes in four patients.
- In one case, this occurred during rapid pacing for atrial flutter due to inadvertent catheter placement in the right ventricle.
- In three other cases, the arrhythmia was provoked during ventricular extrastimulus testing.
Findings:
- Right ventricular electrical stimulation is a potent trigger for torsade de pointes.
- The arrhythmia can be induced irrespective of the classical predisposing factors in some instances.
- Ventricular extrastimulus testing can reveal this arrhythmogenic potential.
Implications:
- These findings suggest that right ventricular electrical stimulation, particularly during electrophysiological procedures, can precipitate torsade de pointes.
- Clinicians should be aware of this potential complication during interventions involving right ventricular pacing or stimulation.
- Further research may elucidate the specific mechanisms underlying stimulation-induced torsade de pointes in diverse clinical settings.