Torsade de Pointes Due to QT Prolongation after Pulmonary Vein Isolation for Persistent Atrial Fibrillation

Abstract

We herein report a 60-year-old woman with long-standing persistent atrial fibrillation (AF) who developed QT prolongation and torsade de pointes (TdP) after pulmonary vein isolation (PVI). When electrical cardioversion was performed three months before PVI, prominent QT prolongation was not observed. QT prolongation emerged after PVI and was sustained until AF recurrence on the third day after ablation, and TdP disappeared along with AF recurrence. PVI affects the ganglionated plexi around the atrium, leading to modification of the intrinsic cardiac autonomic system. This case indicates that PVI has the potential risk of inducing lethal ventricular arrhythmias due to QT prolongation

Does pulmonary vein isolation prolong QT-interval?— Authors’ reply

“…Recently, Chikata et al . 6 published an interesting case report of Torsade de Pointes due to QT prolongation after PVI. Clearly, we have different experiences and therefore endorse their 1 suggestion to perform multi-centre studies with large number of patients and many time courses to clarify the influence of PVI on the QT-interval.…”