Editorial
The pause that refreshes, or does it? Mechanisms in torsades de pointes
| The first 150 words of the full text of this article appear below. |
Dessertenne,
who coined the term "torsades de pointes", was one of the first to
draw attention to the association of long QT related arrhythmia
(commonly caused by heart block or drugs) and underlying
bradycardia.1 Indeed, the
"short-long-short" series of cycles before torsade de pointes is so
characteristic of acquired "long QT syndrome" (LQTS) that lack of a
"pause" before onset calls into question the
diagnosis.2 3 Some
features of the congenital LQTS are very similar to those in the
acquired form. These include a preponderance of women among patients
who are symptomatic with syncope or sudden death, and the possible potentiating role of hypokalaemia in the genesis of the arrhythmia. Indeed, extraordinary advances in our understanding of the molecular basis of the congenital and acquired syndromes now point to common mechanisms that underlie these two closely related
entities.4 5 However,
despite considerable attention to the electrocardiographic features of
these diseases, it is
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