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Polymorphic ventricular arrhythmia triggered by temporary epicardial right ventricular stimulation after cardiac surgery  Carlos Lopez, MD, Teresa Oloriz,

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Presentation on theme: "Polymorphic ventricular arrhythmia triggered by temporary epicardial right ventricular stimulation after cardiac surgery  Carlos Lopez, MD, Teresa Oloriz,"— Presentation transcript:

1 Polymorphic ventricular arrhythmia triggered by temporary epicardial right ventricular stimulation after cardiac surgery  Carlos Lopez, MD, Teresa Oloriz, MD, PhD, Naiara Calvo, MD, PhD, Isabel Sancho, MD, Francisco Diaz, MD, Antonio Asso, MD, PhD  HeartRhythm Case Reports  Volume 3, Issue 12, Pages (December 2017) DOI: /j.hrcr Copyright © 2017 Heart Rhythm Society Terms and Conditions

2 Figure 1 A: Chest radiograph shows transvenous endocardial pacing electrode into the right ventricle and single-chamber pacemaker. B: Electrocardiogram (ECG) illustrates wide QRS complexes with left bundle branch block morphology, indicating the stimulation from the right ventricle, with a corrected QT interval of 480 ms. C: Chest computed tomography scan. Red arrow indicates the temporary epicardial lead in the right ventricle free wall. In this slice we can also see the definitive pacemaker lead across the right atrium and the mitral prosthesis and tricuspid ring. D: During temporary epicardial stimulation, the ECG shows a more prominent R wave in V1-V2 derivations and a corrected QT interval of 646 ms. E: The external telemetry system illustrates early afterdepolarizations, manifested as short-coupled premature ventricular contractions with “R on T” phenomenon, causing torsades de pointes with immediate loss of pulse and respiratory arrest. F: Reiterative torsades de pointes episodes were recorded at 24 hours heart rhythm monitoring. Art P = arterial pressure; RR = respiratory rate. HeartRhythm Case Reports 2017 3, DOI: ( /j.hrcr ) Copyright © 2017 Heart Rhythm Society Terms and Conditions

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