Sudden Death During Holter Monitoring

Report:

Supraventricular and ventricular bigeminy

Prolonged QT interval (0.64”)

Multiform, probably torsade de pointes, ventricular tachycardia

Comment:

This patient was on digoxin and quinidine. The final (and fatal) paroxysm is initiated by a late VEB; the tachycardia appears to be a true torsade de pointes142.

An episode of definite repolarisation alternans (Fig 198a) preceded the torsade.

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