His Bundle Pacing in Amiodarone-Induced Complete Heart Block, QT Prolongation, and Torsade de Pointes

Vern Hsen Tan; Colin Yeo; Thuan Ngee Tan; Kelvin Wong

doi:10.1016/j.jaccas.2020.02.028

His Bundle Pacing in Amiodarone-Induced Complete Heart Block, QT Prolongation, and Torsade de Pointes

JACC Case Rep. 2020 May 20;2(5):780-784. doi: 10.1016/j.jaccas.2020.02.028. eCollection 2020 May.

Authors

Vern Hsen Tan¹, Colin Yeo¹, Thuan Ngee Tan¹, Kelvin Wong^{1

2}

Affiliations

¹ Cardiology Department, Changi General Hospital, Singapore.
² Orchard Heart Specialist Clinic, Mount Elizabeth Hospital, Singapore.

Abstract

A woman with ischemic cardiomyopathy presented with recurrent syncope. Electrocardiogram showed complete heart block and torsade de pointes (TdP) secondary to amiodarone, recently started for paroxysmal atrial fibrillation. We describe a novel application of His bundle pacing that suppressed TdP and corrected the underlying left bundle branch block. (Level of Difficulty: Intermediate.).

Keywords: CS, coronary sinus; His bundle pacing; LV, left ventricle; LVEF, left ventricular ejection fraction; RV, right ventricle; TdP, torsade de pointes; amiodarone; atrial fibrillation; cardiac pacemaker; cardiomyopathy; complete heart block.

Publication types

Case Reports