Torsade de Pointes and demand endocavitary pacemaker. Report of one case

We report a 81 years old female with a severe aortic insufficiency, treated with diuretics and antidepressants admitted due to recurrent syncopal epis odes. During the first syncopal episode, and atrioventricular block was det ected and an endocavitary demand pacemaker implanted. Two years later, she had a new syncope without evidences of pacemaker failure. The EKG during pa cemaker rhythm showed a prolonged QT interval. During hospital monitoring, she presented a self limited polymorphic ventricular tachycardia (Torsade d e Pointes). Consequently, the pacemaker was programmed at a greater frequen cy, and the QT interval shortened from 0.73 to 0.56 sec. Thereafter, the pa tient no longer had tachycardia or syncopal episodes, after one year of fol low up.