Korean J Intern Med.  2011 Mar;26(1):99-102. 10.3904/kjim.2011.26.1.99.

Complete Atrioventricular Block-Induced Torsade de Pointes, Manifested by Epilepsy

• Jeon JH
• Her SH
• Chin JY
• Park KH
• Yoon HJ
• Lee JM
• Jin SW

• KMID: 1036158
• DOI: http://doi.org/10.3904/kjim.2011.26.1.99

Abstract

Complete atrioventricular (AV) block is frequently regarded as a cause of informed syncopal attacks, even though the escape rhythm is maintained. Torsade de pointes (TdP) may be a significant complication of AV block associated with QT prolongation. Here, we report the case of a 42-year-old female who was referred to our hospital due to recurrent seizure-like attacks while taking anti-convulsant drugs at a psychiatric hospital. TdP with a long QT interval (corrected QT = 0.591 seconds) was observed on an electrocardiogram (ECG) taken in the emergency department. The patient's drug history revealed olanzapine as the suspicious agent. Even after the medication was stopped, however, the QT interval remained within an abnormal range and multiple episodes of TdP and related seizure-like symptoms were found via ECG monitoring. A permanent pacemaker was thus implanted, and the ventricular rate was set at over 80 beats/min. There was no recurrence of tachyarrhythmia or other symptoms.

Keyword

Complete atrioventricular block; Pacemaker; Torsade de pointes

MeSH Terms

Adult
Atrioventricular Block/*complications
Benzodiazepines/adverse effects
Electrocardiography
Epilepsy/*etiology
Female
Humans
Pacemaker, Artificial
Torsades de Pointes/*etiology/therapy