Cardiac pacing at a moderate rate successfully treated bradycardia-associated torsade de pointes refractory to magnesium in a patient with long-QT syndrome due to conduction system disease.
Moderate-rate pacing may terminate magnesium-refractory torsades in conduction-system long-QT; single case leaves broader applicability open.
We report a case of bradycardia-associated torsade de pointes in which the underlying long-QT syndrome appeared to be attributable to primary cardiac conducting system disease. Our patient presented complaining of presyncope and syncope. Serial electrocardiograms obtained over a period of 10 years demonstrated slowly progressive conduction system abnormalities, and evaluation revealed no other cause. The patient's dysrhythmia was refractory to magnesium but abated with cardiac pacing at a moderate rate. A review of the relevant literature on congenital and acquired long-QT syndrome is included.
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Ashworth et al. (2005) studied this question.
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