Why the study?
Does temporary overdrive pacing resolve persistent torsades de pointes and pulseless ventricular tachycardia in a patient with nimetazepam abuse?
Does temporary overdrive pacing resolve persistent torsades de pointes and pulseless ventricular tachycardia in a patient with nimetazepam abuse?
Temporary overdrive pacing can successfully suppress persistent torsades de pointes and pulseless ventricular tachycardia refractory to electrolyte correction.
Nimetazepam abuse may precipitate refractory torsades; this Level 5 case leaves open its proarrhythmic risk.
A 53-year-old presented to the emergency department following a fall and was found to have recurrent episodes of torsades de pointes and pulseless ventricular tachycardia on cardiac monitoring. He had been abusing nimetazepam for sleep issues over the preceding one month. Despite correction of electrolytes, the arrhythmias were persistent which necessitated temporary overdrive pacing. The patient made an uneventful recovery and the temporary pacing was successfully removed with no recurrence of the malignant arrhythmias prior to discharge.
No takes yet. Share an insight, caveat, or question.
Koh et al. (2024) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: