Torsades de pointes following radiofrequency catheter His ablation.

Abstract

A case of polymorphic ventricular tachycardia torsade de pointes type, appearing in a 70-year-old female following radiofrequency catheter His ablation, is presented. The substrate was slow rate with ventricular bigeminy and QT prolongation which appeared after ablation. The same phenomenon reappeared after permanent VVIR pacemaker implantation with a basal rate of 55 beats/min. One episode of polymorphic ventricular tachycardia deteriorated into ventricular fibrillation, requiring a 360-J DC shock. Raising the pacemaker rate to 80 beats/min abolished the arrhythmias.

AI evidence extraction

Main findings

A 70-year-old female developed torsade de pointes-type polymorphic ventricular tachycardia following radiofrequency catheter His ablation, associated with slow rate, ventricular bigeminy, and QT prolongation. Arrhythmias recurred after VVIR pacemaker implantation at 55 bpm; one episode progressed to ventricular fibrillation requiring 360-J DC shock. Increasing the pacemaker basal rate to 80 bpm abolished the arrhythmias.

Outcomes measured

• torsade de pointes (polymorphic ventricular tachycardia)
• ventricular fibrillation
• QT prolongation
• ventricular bigeminy

Limitations

• Single-patient case report
• No radiofrequency exposure parameters (e.g., frequency, power, duration) reported
• Causality cannot be established from case description alone

Suggested hubs

• occupational-exposure (0.2)
  Involves radiofrequency catheter ablation in a clinical procedure, but not an environmental/consumer EMF exposure context.

{
    "study_type": "case_report",
    "exposure": {
        "band": null,
        "source": "radiofrequency catheter His ablation",
        "frequency_mhz": null,
        "sar_wkg": null,
        "duration": null
    },
    "population": "70-year-old female",
    "sample_size": 1,
    "outcomes": [
        "torsade de pointes (polymorphic ventricular tachycardia)",
        "ventricular fibrillation",
        "QT prolongation",
        "ventricular bigeminy"
    ],
    "main_findings": "A 70-year-old female developed torsade de pointes-type polymorphic ventricular tachycardia following radiofrequency catheter His ablation, associated with slow rate, ventricular bigeminy, and QT prolongation. Arrhythmias recurred after VVIR pacemaker implantation at 55 bpm; one episode progressed to ventricular fibrillation requiring 360-J DC shock. Increasing the pacemaker basal rate to 80 bpm abolished the arrhythmias.",
    "effect_direction": "harm",
    "limitations": [
        "Single-patient case report",
        "No radiofrequency exposure parameters (e.g., frequency, power, duration) reported",
        "Causality cannot be established from case description alone"
    ],
    "evidence_strength": "very_low",
    "confidence": 0.7800000000000000266453525910037569701671600341796875,
    "peer_reviewed_likely": "yes",
    "keywords": [
        "torsade de pointes",
        "polymorphic ventricular tachycardia",
        "ventricular fibrillation",
        "QT prolongation",
        "radiofrequency catheter ablation",
        "His ablation",
        "VVIR pacemaker"
    ],
    "suggested_hubs": [
        {
            "slug": "occupational-exposure",
            "weight": 0.200000000000000011102230246251565404236316680908203125,
            "reason": "Involves radiofrequency catheter ablation in a clinical procedure, but not an environmental/consumer EMF exposure context."
        }
    ]
}

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