Pacing-induced torsades de pointes after the short-long-short sequence in a patient with a biventricular defibrillator: What is the mechanism?

摘要

Introduction: Induction of ventricular arrhythmias with a pacing stimulus on the T wave is a possible (fortunately rare) complication of cardiac pacing and usually occurs in the setting of ischemia or structural heart disease. This phenomenon can also occur in cardiac resynchronization therapy (CRT) when programmed parameters and functioning algorithms create favorable conditions. In this article, we describe the case of a patient with a biventricular defibrillator in whom a "series of unfortunate events" led to pacing-induced torsades de pointes with consequent defibrillator shocks.