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She began intravenous therapy with magnesium sulfate and amiodarone without rhythm stabilization&#46; Endotracheal intubation with mechanical ventilation was required in the context of multiple defibrillations&#46; Lidocaine was added to amiodarone&#44; also without success&#46; A temporary pacemaker was implanted for ventricular pacing&#44; but it proved to be arrhythmogenic &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>A&#41; and was promptly removed&#46; Coronary angiography was normal&#46; Veno-arterial extracorporeal membrane oxygenation &#40;ECMO&#41; was introduced because of hemodynamic instability&#44; and removed after 24 hours due to lower limb ischemia&#46; At this stage lidocaine was replaced by isoprenaline&#44; maintaining amiodarone&#44; with rhythm stabilization&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">In an attempt to optimize therapy&#44; isoprenaline was suspended at 48 hours and replaced by a beta-blocker in combination with amiodarone&#46; This change triggered new episodes of nonsustained PVT&#46; Isoprenaline was then reintroduced&#44; achieving rhythm stabilization again&#46; In the periods when the patient was without isoprenaline therapy&#44; 65 defibrillations were performed&#46; After nine days&#44; isoprenaline was suspended&#44; maintaining only amiodarone 200 mg&#47;day&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">After rhythm stability was achieved&#44; the etiological study was completed by performing cardiac magnetic resonance imaging&#44; which was normal &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>&#41;&#46; Reassessment of the ECG tracings showed that all episodes of PVT were preceded by PVCs with no compensatory pause &#40;absence of long R-R interval&#41;&#44; followed by a short-coupling PVC &#40;280&#8211;290 ms&#41; &#40;<a class="elsevierStyleCrossRefs" href="#fig0010">Figures 2B and 4</a>&#41;&#46; At this point&#44; taking into account the patient&#39;s clinical history and complementary tests&#44; a diagnosis of short-coupled variant torsade de pointes was established&#46; Amiodarone was suspended and verapamil was started &#40;120 mg twice daily&#41;&#46; A cardioverter-defibrillator was also implanted with permanent atrial pacing&#46; Genetic study was performed&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The hospitalization was prolonged by lower limb ischemia associated with ECMO cannulation requiring surgery &#40;fasciectomy and thromboembolectomy in separate operations&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Six months after hospital discharge the patient was asymptomatic&#44; with Holter monitoring showing sinus rhythm alternating with atrial pacing&#44; without PVC or PVT&#46; Genetic testing to identify mutations responsible for long QT syndrome and catecholaminergic tachycardia was negative&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Discussion</span><p id="par0040" class="elsevierStylePara elsevierViewall">PVT can be associated with several diseases&#44; but mostly appears in the presence of congenital or acquired long QT interval<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">1</span></a> or bradycardia&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">2&#8211;4</span></a> It is common in patients with sudden cardiac death &#40;SCD&#41; without structural heart disease&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">1</span></a> In torsade de pointes electrolyte and metabolic disturbances should be excluded&#44; since changes in potassium channels create conditions for early afterdepolarizations &#40;due to modification in ventricular repolarization&#41;&#44; triggering PVC and PVT &#40;perpetuated by re-entry phenomena&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">2</span></a> In the context of a pharmacological iatrogenic cause&#44; PVT usually occurs when the corrected QT interval &#40;QTc&#41; is &#62;500 ms &#40;90&#37; of cases&#41; or more than 25&#37; of baseline QTc&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">2&#44;5</span></a> It is also important to exclude relevant family history&#44; including SCD&#44; heart disease or rhythm disturbances&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">In the case presented&#44; all the above causes were excluded&#46; The 12-lead ECG was normal in terms of heart rhythm&#44; without prolongation of QTc interval and without electrical instability &#40;alternating T&#44; notched T and U waves and ST-segment changes&#41;&#46; Therefore&#44; in this context long or short QT syndrome&#44; Brugada syndrome or early repolarization syndrome were unlikely&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">6</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Analysis of periods of torsade de pointes in our patient did not demonstrate short-long-short sequences&#44; which are a common characteristic in arrhythmias triggered by electrolyte&#44; metabolic&#44; or pharmacological alterations&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">1&#44;2&#44;6</span></a> However&#44; it revealed a PVC not followed by a compensatory pause &#40;absence of long R-R&#41; and a short-coupled interval &#40;QTc 280&#8211;290 ms&#41;&#44; similar to an R-on-T phenomenon&#46; This was first described in 1994 by Leenhardt et al&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">7</span></a> in a series of 14 patients without structural heart disease and a history of syncope related to PVT with normal QTc and short-coupled PVC &#40;&#60;300 ms&#41;&#46; As this is a rare condition&#44; there are only short descriptive series and isolated case reports&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">In our patient the arrhythmic storm was refractory and perpetuated by ventricular pacing and was only controlled with administration of isoprenaline&#46; As pointed out by Chiladakis et al&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">8</span></a> in a similar case&#44; ventricular pacing appears to be responsible for increasing dispersion in ventricular activation time and the heterogeneity of ventricular repolarization&#44; aggravating the arrhythmia&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">7&#44;8</span></a> Isoprenaline and atrial pacing &#40;used on the same principle&#41; limit repolarization dispersion&#44; potentially controlling the arrhythmia&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">7&#44;8</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Catecholaminergic polymorphic ventricular tachycardia appeared to be unlikely in our patient&#44; since no stress or adrenergic stimulation was identified&#44; and electrical stability was achieved under isoprenaline&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">6</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Structural heart disease was excluded&#44; as well as significant coronary heart disease by cardiac catheterization&#46; The endomyocardial biopsy performed at the time of the first event was nonspecific&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">In view of the above facts and taking into account especially the presence of a short-coupled interval preceding PVT&#44; the diagnosis of short-coupled variant torsade de pointes was established&#46; Amiodarone was accordingly replaced by verapamil at maximum tolerated dose&#44; since there is no established optimal target dose&#44; given the small number of series and case reports&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">In the series by Leenhardt et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">7</span></a> verapamil was the only useful drug&#44; in contrast to other antiarrhythmic drugs&#44; including beta-blockers and amiodarone&#44; but did not change the risk of SCD&#46; Its value is due to its reduction of the refractory period&#44; increasing the coupling interval and decreasing the number of PVCs&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">8&#8211;11</span></a> Eisenberg et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">12</span></a> in a series of 15 patients&#44; showed that a shorter PVC coupling interval increased the risk of SCD&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The fact that our patient remained stable over a long period of time appears to be independent of amiodarone therapy&#44; given her irregular compliance and the subtherapeutic dose&#46; Dual-chamber ICD implantation is the only way to reduce mortality in these patients&#46; In the series by Leenhardt et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">7</span></a> torsade de pointes and VF were documented preceded by short-coupled PVCs&#46; When programming the ICD&#44; atrial pacing was preferred because it appeared to be responsible for better clinical stabilization&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">The use of ECMO in these cases is empirical&#46; Indication for ECMO is established in cardiogenic shock related to acute myocardial infarction and myocarditis&#44; but not in cases of arrhythmic storm&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">13</span></a> In an emergency context&#44; its use is described in arrhythmic storms due to Brugada syndrome&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">13</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">The utility of EPS and ablation in these patients is controversial&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">10</span></a> In the series by Leenhardt et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">7</span></a> only two patients had inducible PVT&#44; although in some cases the triggering PVCs were monomorphic&#46; EPS is indicated in polymorphic VT without structural heart disease refractory to antiarrhythmic therapy&#44; when successful ablation is expected&#44; with mapping preferably done during the arrhythmic storm&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">14</span></a> Successful ablation does not invalidate the need for an ICD&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">14</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Short-coupled variant torsade de pointes may be associated with genetic disorders of variable penetrance&#46; In the series by Leenhardt et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">7</span></a> four patients had a family history of SCD&#46; However&#44; the management of these patients in terms of genetic and family screening is not well established&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">6</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">With this case&#44; we aimed to demonstrate the need for an integrated assessment of clinical data and findings of complementary exams&#46; This integration is crucial for the diagnosis of rare diseases&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Ethical disclosures</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Protection of human and animal subjects</span><p id="par0105" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Confidentiality of data</span><p id="par0110" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Right to privacy and informed consent</span><p id="par0115" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conflicts of interest</span><p id="par0120" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A 49-year-old woman&#44; with no relevant family history&#44; was admitted in 1996 for arrhythmic storm with polymorphic ventricular tachycardia &#40;torsade de pointes&#41; which degenerated into ventricular fibrillation&#46; Iatrogenic causes were excluded&#44; the electrocardiogram &#40;ECG&#41; was normal and there was no structural heart disease&#46; She refused cardioverter-defibrillator implantation&#46; Treatment was begun with amiodarone&#44; which she took irregularly&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">She remained asymptomatic until 2014 when she was admitted for a new arrhythmic storm with torsade de pointes&#44; refractory to antiarrhythmic therapy and aggravated by ventricular pacing &#40;65 defibrillations&#41;&#46; She had frequent ventricular extrasystoles &#40;with short-coupled period &#60;300 ms&#41; preceding the tachycardia&#46; After administration of isoprenaline infusion electric stability was maintained&#46; In this setting and in the absence of structural heart disease or iatrogenic cause&#44; a diagnosis of short-coupled variant torsade de pointes was established&#46; A cardioverter-defibrillator was implanted and she was treated with verapamil&#44; without recurrence of arrhythmias&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Mulher de 49 anos&#44; sem hist&#243;ria familiar de relevo&#46; Em 1996 foi admitida no hospital por tempestade arr&#237;tmica&#58; taquicardias ventriculares polim&#243;rficas tipo <span class="elsevierStyleItalic">torsade de pointes</span>&#44; que degeneraram em fibrilha&#231;&#227;o ventricular&#46; No estudo realizado foram exclu&#237;das iatrogenias&#44; apresentava eletrocardiograma normal e aus&#234;ncia de cardiopatia estrutural&#46; Recusou implanta&#231;&#227;o de cardiodesfibrilhador&#46; Ficou medicada com amiodarona&#44; com cumprimento irregular&#46; Assintom&#225;tica at&#233; 2014&#44; altura em que teve nova tempestade arr&#237;tmica com taquicardias ventriculares polim&#243;rficas&#44; refrat&#225;rias a antiarr&#237;tmicos e agravadas por <span class="elsevierStyleItalic">pacing</span> ventricular &#40;65 desfibrilha&#231;&#245;es&#41;&#46; Ap&#243;s introdu&#231;&#227;o de isoprenalina em perfus&#227;o manteve estabilidade de ritmo&#44; constatando-se extrass&#237;stoles ventriculares com per&#237;odo de acoplamento curto &#40;&#60;300 ms&#41; a preceder as taquicardias&#46; O diagn&#243;stico de <span class="elsevierStyleItalic">short coupled variant torsade de pointes</span> foi estabelecido na aus&#234;ncia de iatrogenia ou cardiopatia estrutural&#46; Implantou cardiodesfibrilhador e ficou medicada com verapamil&#44; sem recorr&#234;ncia de eventos arr&#237;tmicos&#46;</p></span>"
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      "seccion" => array:1 [
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            0 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The long QT syndrome&#58; a transatlantic clinical approach to diagnosis and therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46;J&#46; Schwartz"
                            1 => "M&#46;J&#46; Ackerman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/eht089"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2013"
                        "volumen" => "34"
                        "paginaInicial" => "3109"
                        "paginaFinal" => "3116"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23509228"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Torsade de pointes&#58; the clinical considerations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46;M&#46; Gowda"
                            1 => "I&#46;A&#46; Khan"
                            2 => "S&#46;L&#46; Wilbur"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijcard.2003.04.055"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Cardiol"
                        "fecha" => "2004"
                        "volumen" => "96"
                        "paginaInicial" => "1"
                        "paginaFinal" => "6"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15203254"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0085"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short QT syndrome presenting as syncope&#58; how short is too short&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "G&#46; Portugal"
                            1 => "M&#46;M&#46; Oliveira"
                            2 => "P&#46;S&#46; Cunha"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.repc.2014.05.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2014"
                        "volumen" => "33"
                        "paginaInicial" => "649&#46;e1"
                        "paginaFinal" => "649&#46;e6"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25442000"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "EHRA&#47;HRS&#47;APHRS expert consensus on ventricular arrhythmias"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46;T&#46; Pedersen"
                            1 => "G&#46;N&#46; Kay"
                            2 => "J&#46; Kalman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/europace/euu194"
                      "Revista" => array:6 [
                        "tituloSerie" => "Europace"
                        "fecha" => "2014"
                        "volumen" => "16"
                        "paginaInicial" => "1257"
                        "paginaFinal" => "1283"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25172618"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
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                        "link" => array:1 [
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                        ]
                      ]
                    ]
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                      "Revista" => array:6 [
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                        "link" => array:1 [
                          0 => array:2 [
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                          "etal" => true
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                    ]
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                        "paginaFinal" => "275"
                        "link" => array:1 [
                          0 => array:2 [
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                        ]
                      ]
                    ]
                  ]
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                        "link" => array:1 [
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Case report
Arrhythmic storm: Short-coupled variant torsade de pointes
Tempestade arrítmica: variante torsade de pointes de acoplamento curto
Ana Rita Godinho
Corresponding author
, Cecília Frutuoso, Mariana Vasconcelos, Paula Dias, Raquel Garcia, Teresa Pinho, Vítor Araújo, Maria Júlia Maciel
Serviço de Cardiologia, Hospital de São João, Porto, Portugal
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Case report</span><p id="par0005" class="elsevierStylePara elsevierViewall">A 49-year-old woman&#44; with no relevant family history and not taking any prescribed or illegal drugs&#44; was admitted in 1996 for arrhythmic storm with polymorphic ventricular tachycardia &#40;PVT&#41; &#40;torsade de pointes&#41;&#44; with some episodes degenerating into ventricular fibrillation &#40;VF&#41; refractory to lidocaine&#44; procainamide and propranolol and requiring several defibrillations&#46; The 12-lead ECG was normal and electrolyte and metabolic abnormalities were excluded&#46; Stabilization was achieved with amiodarone&#46; During hospitalization she underwent transthoracic echocardiography &#40;TTE&#41; and cardiac catheterization&#44; which were normal&#46; Nonspecific characteristics were observed on endomyocardial biopsy&#46; The electrophysiological study &#40;EPS&#41; performed under amiodarone &#40;400 mg&#47;day&#41; was negative for inducible ventricular tachycardia&#46; An implantable cardioverter-defibrillator &#40;ICD&#41; was proposed&#44; but the patient refused&#46; She was discharged under treatment with amiodarone and referred for an arrhythmia consultation&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">During 18 years of follow-up she took amiodarone irregularly and with subtherapeutic doses &#40;100 mg three times a week&#41;&#46; Holter monitoring documented isolated premature ventricular contractions &#40;PVCs&#41;&#44; duplets and nonsustained PVT &#40;all asymptomatic&#41;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In 2014 she was readmitted for recurrent syncope due to PVT &#40;torsade de pointes&#41;&#46; The 12-lead ECG &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41; and TTE were normal&#46; Electrolyte and metabolic abnormalities and iatrogenic toxicological causes were excluded&#46; She began intravenous therapy with magnesium sulfate and amiodarone without rhythm stabilization&#46; Endotracheal intubation with mechanical ventilation was required in the context of multiple defibrillations&#46; Lidocaine was added to amiodarone&#44; also without success&#46; A temporary pacemaker was implanted for ventricular pacing&#44; but it proved to be arrhythmogenic &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>A&#41; and was promptly removed&#46; Coronary angiography was normal&#46; Veno-arterial extracorporeal membrane oxygenation &#40;ECMO&#41; was introduced because of hemodynamic instability&#44; and removed after 24 hours due to lower limb ischemia&#46; At this stage lidocaine was replaced by isoprenaline&#44; maintaining amiodarone&#44; with rhythm stabilization&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">In an attempt to optimize therapy&#44; isoprenaline was suspended at 48 hours and replaced by a beta-blocker in combination with amiodarone&#46; This change triggered new episodes of nonsustained PVT&#46; Isoprenaline was then reintroduced&#44; achieving rhythm stabilization again&#46; In the periods when the patient was without isoprenaline therapy&#44; 65 defibrillations were performed&#46; After nine days&#44; isoprenaline was suspended&#44; maintaining only amiodarone 200 mg&#47;day&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">After rhythm stability was achieved&#44; the etiological study was completed by performing cardiac magnetic resonance imaging&#44; which was normal &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>&#41;&#46; Reassessment of the ECG tracings showed that all episodes of PVT were preceded by PVCs with no compensatory pause &#40;absence of long R-R interval&#41;&#44; followed by a short-coupling PVC &#40;280&#8211;290 ms&#41; &#40;<a class="elsevierStyleCrossRefs" href="#fig0010">Figures 2B and 4</a>&#41;&#46; At this point&#44; taking into account the patient&#39;s clinical history and complementary tests&#44; a diagnosis of short-coupled variant torsade de pointes was established&#46; Amiodarone was suspended and verapamil was started &#40;120 mg twice daily&#41;&#46; A cardioverter-defibrillator was also implanted with permanent atrial pacing&#46; Genetic study was performed&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The hospitalization was prolonged by lower limb ischemia associated with ECMO cannulation requiring surgery &#40;fasciectomy and thromboembolectomy in separate operations&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Six months after hospital discharge the patient was asymptomatic&#44; with Holter monitoring showing sinus rhythm alternating with atrial pacing&#44; without PVC or PVT&#46; Genetic testing to identify mutations responsible for long QT syndrome and catecholaminergic tachycardia was negative&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Discussion</span><p id="par0040" class="elsevierStylePara elsevierViewall">PVT can be associated with several diseases&#44; but mostly appears in the presence of congenital or acquired long QT interval<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">1</span></a> or bradycardia&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">2&#8211;4</span></a> It is common in patients with sudden cardiac death &#40;SCD&#41; without structural heart disease&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">1</span></a> In torsade de pointes electrolyte and metabolic disturbances should be excluded&#44; since changes in potassium channels create conditions for early afterdepolarizations &#40;due to modification in ventricular repolarization&#41;&#44; triggering PVC and PVT &#40;perpetuated by re-entry phenomena&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">2</span></a> In the context of a pharmacological iatrogenic cause&#44; PVT usually occurs when the corrected QT interval &#40;QTc&#41; is &#62;500 ms &#40;90&#37; of cases&#41; or more than 25&#37; of baseline QTc&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">2&#44;5</span></a> It is also important to exclude relevant family history&#44; including SCD&#44; heart disease or rhythm disturbances&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">In the case presented&#44; all the above causes were excluded&#46; The 12-lead ECG was normal in terms of heart rhythm&#44; without prolongation of QTc interval and without electrical instability &#40;alternating T&#44; notched T and U waves and ST-segment changes&#41;&#46; Therefore&#44; in this context long or short QT syndrome&#44; Brugada syndrome or early repolarization syndrome were unlikely&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">6</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Analysis of periods of torsade de pointes in our patient did not demonstrate short-long-short sequences&#44; which are a common characteristic in arrhythmias triggered by electrolyte&#44; metabolic&#44; or pharmacological alterations&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">1&#44;2&#44;6</span></a> However&#44; it revealed a PVC not followed by a compensatory pause &#40;absence of long R-R&#41; and a short-coupled interval &#40;QTc 280&#8211;290 ms&#41;&#44; similar to an R-on-T phenomenon&#46; This was first described in 1994 by Leenhardt et al&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">7</span></a> in a series of 14 patients without structural heart disease and a history of syncope related to PVT with normal QTc and short-coupled PVC &#40;&#60;300 ms&#41;&#46; As this is a rare condition&#44; there are only short descriptive series and isolated case reports&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">In our patient the arrhythmic storm was refractory and perpetuated by ventricular pacing and was only controlled with administration of isoprenaline&#46; As pointed out by Chiladakis et al&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">8</span></a> in a similar case&#44; ventricular pacing appears to be responsible for increasing dispersion in ventricular activation time and the heterogeneity of ventricular repolarization&#44; aggravating the arrhythmia&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">7&#44;8</span></a> Isoprenaline and atrial pacing &#40;used on the same principle&#41; limit repolarization dispersion&#44; potentially controlling the arrhythmia&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">7&#44;8</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Catecholaminergic polymorphic ventricular tachycardia appeared to be unlikely in our patient&#44; since no stress or adrenergic stimulation was identified&#44; and electrical stability was achieved under isoprenaline&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">6</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Structural heart disease was excluded&#44; as well as significant coronary heart disease by cardiac catheterization&#46; The endomyocardial biopsy performed at the time of the first event was nonspecific&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">In view of the above facts and taking into account especially the presence of a short-coupled interval preceding PVT&#44; the diagnosis of short-coupled variant torsade de pointes was established&#46; Amiodarone was accordingly replaced by verapamil at maximum tolerated dose&#44; since there is no established optimal target dose&#44; given the small number of series and case reports&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">In the series by Leenhardt et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">7</span></a> verapamil was the only useful drug&#44; in contrast to other antiarrhythmic drugs&#44; including beta-blockers and amiodarone&#44; but did not change the risk of SCD&#46; Its value is due to its reduction of the refractory period&#44; increasing the coupling interval and decreasing the number of PVCs&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">8&#8211;11</span></a> Eisenberg et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">12</span></a> in a series of 15 patients&#44; showed that a shorter PVC coupling interval increased the risk of SCD&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The fact that our patient remained stable over a long period of time appears to be independent of amiodarone therapy&#44; given her irregular compliance and the subtherapeutic dose&#46; Dual-chamber ICD implantation is the only way to reduce mortality in these patients&#46; In the series by Leenhardt et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">7</span></a> torsade de pointes and VF were documented preceded by short-coupled PVCs&#46; When programming the ICD&#44; atrial pacing was preferred because it appeared to be responsible for better clinical stabilization&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">The use of ECMO in these cases is empirical&#46; Indication for ECMO is established in cardiogenic shock related to acute myocardial infarction and myocarditis&#44; but not in cases of arrhythmic storm&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">13</span></a> In an emergency context&#44; its use is described in arrhythmic storms due to Brugada syndrome&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">13</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">The utility of EPS and ablation in these patients is controversial&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">10</span></a> In the series by Leenhardt et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">7</span></a> only two patients had inducible PVT&#44; although in some cases the triggering PVCs were monomorphic&#46; EPS is indicated in polymorphic VT without structural heart disease refractory to antiarrhythmic therapy&#44; when successful ablation is expected&#44; with mapping preferably done during the arrhythmic storm&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">14</span></a> Successful ablation does not invalidate the need for an ICD&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">14</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Short-coupled variant torsade de pointes may be associated with genetic disorders of variable penetrance&#46; In the series by Leenhardt et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">7</span></a> four patients had a family history of SCD&#46; However&#44; the management of these patients in terms of genetic and family screening is not well established&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">6</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">With this case&#44; we aimed to demonstrate the need for an integrated assessment of clinical data and findings of complementary exams&#46; 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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A 49-year-old woman&#44; with no relevant family history&#44; was admitted in 1996 for arrhythmic storm with polymorphic ventricular tachycardia &#40;torsade de pointes&#41; which degenerated into ventricular fibrillation&#46; Iatrogenic causes were excluded&#44; the electrocardiogram &#40;ECG&#41; was normal and there was no structural heart disease&#46; She refused cardioverter-defibrillator implantation&#46; Treatment was begun with amiodarone&#44; which she took irregularly&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">She remained asymptomatic until 2014 when she was admitted for a new arrhythmic storm with torsade de pointes&#44; refractory to antiarrhythmic therapy and aggravated by ventricular pacing &#40;65 defibrillations&#41;&#46; She had frequent ventricular extrasystoles &#40;with short-coupled period &#60;300 ms&#41; preceding the tachycardia&#46; After administration of isoprenaline infusion electric stability was maintained&#46; In this setting and in the absence of structural heart disease or iatrogenic cause&#44; a diagnosis of short-coupled variant torsade de pointes was established&#46; A cardioverter-defibrillator was implanted and she was treated with verapamil&#44; without recurrence of arrhythmias&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Mulher de 49 anos&#44; sem hist&#243;ria familiar de relevo&#46; Em 1996 foi admitida no hospital por tempestade arr&#237;tmica&#58; taquicardias ventriculares polim&#243;rficas tipo <span class="elsevierStyleItalic">torsade de pointes</span>&#44; que degeneraram em fibrilha&#231;&#227;o ventricular&#46; No estudo realizado foram exclu&#237;das iatrogenias&#44; apresentava eletrocardiograma normal e aus&#234;ncia de cardiopatia estrutural&#46; Recusou implanta&#231;&#227;o de cardiodesfibrilhador&#46; Ficou medicada com amiodarona&#44; com cumprimento irregular&#46; Assintom&#225;tica at&#233; 2014&#44; altura em que teve nova tempestade arr&#237;tmica com taquicardias ventriculares polim&#243;rficas&#44; refrat&#225;rias a antiarr&#237;tmicos e agravadas por <span class="elsevierStyleItalic">pacing</span> ventricular &#40;65 desfibrilha&#231;&#245;es&#41;&#46; Ap&#243;s introdu&#231;&#227;o de isoprenalina em perfus&#227;o manteve estabilidade de ritmo&#44; constatando-se extrass&#237;stoles ventriculares com per&#237;odo de acoplamento curto &#40;&#60;300 ms&#41; a preceder as taquicardias&#46; O diagn&#243;stico de <span class="elsevierStyleItalic">short coupled variant torsade de pointes</span> foi estabelecido na aus&#234;ncia de iatrogenia ou cardiopatia estrutural&#46; Implantou cardiodesfibrilhador e ficou medicada com verapamil&#44; sem recorr&#234;ncia de eventos arr&#237;tmicos&#46;</p></span>"
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          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:14 [
            0 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The long QT syndrome&#58; a transatlantic clinical approach to diagnosis and therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46;J&#46; Schwartz"
                            1 => "M&#46;J&#46; Ackerman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/eht089"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2013"
                        "volumen" => "34"
                        "paginaInicial" => "3109"
                        "paginaFinal" => "3116"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23509228"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Torsade de pointes&#58; the clinical considerations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46;M&#46; Gowda"
                            1 => "I&#46;A&#46; Khan"
                            2 => "S&#46;L&#46; Wilbur"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijcard.2003.04.055"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Cardiol"
                        "fecha" => "2004"
                        "volumen" => "96"
                        "paginaInicial" => "1"
                        "paginaFinal" => "6"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15203254"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short QT syndrome presenting as syncope&#58; how short is too short&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "G&#46; Portugal"
                            1 => "M&#46;M&#46; Oliveira"
                            2 => "P&#46;S&#46; Cunha"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.repc.2014.05.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2014"
                        "volumen" => "33"
                        "paginaInicial" => "649&#46;e1"
                        "paginaFinal" => "649&#46;e6"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25442000"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "EHRA&#47;HRS&#47;APHRS expert consensus on ventricular arrhythmias"
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                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46;T&#46; Pedersen"
                            1 => "G&#46;N&#46; Kay"
                            2 => "J&#46; Kalman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/europace/euu194"
                      "Revista" => array:6 [
                        "tituloSerie" => "Europace"
                        "fecha" => "2014"
                        "volumen" => "16"
                        "paginaInicial" => "1257"
                        "paginaFinal" => "1283"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25172618"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0095"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevention of torsade de pointes in hospital settings&#58; a scientific statement from the American Heart Association and the American College of Cardiology Foundation"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "B&#46;J&#46; Drew"
                            1 => "M&#46;J&#46; Ackerman"
                            2 => "M&#46; Funk"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.109.192704"
                      "Revista" => array:7 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2010"
                        "volumen" => "121"
                        "paginaInicial" => "1047"
                        "paginaFinal" => "1060"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20142454"
                            "web" => "Medline"
                          ]
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                          "pii" => "S0090825814013109"
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                          "issn" => "00908258"
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                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "HRS&#47;EHRA&#47;APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46;G&#46; Priori"
                            1 => "A&#46;A&#46; Wilde"
                            2 => "M&#46; Horie"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Europace"
                        "fecha" => "2013"
                        "volumen" => "10"
                        "paginaInicial" => "1932"
                        "paginaFinal" => "1963"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short-coupled variant of torsade de pointes&#46; A new electrocardiographic entity in the spectrum of idiopathic ventricular tachyarrhythmias"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46; Leenhardt"
                            1 => "E&#46; Glaser"
                            2 => "M&#46; Burguera"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "1994"
                        "volumen" => "89"
                        "paginaInicial" => "206"
                        "paginaFinal" => "215"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8281648"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0110"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short-coupled variant of Torsade de Pointes as a cause of electrical storm and aborted sudden cardiac death&#58; insights into mechanism and treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;A&#46; Chiladakis"
                            1 => "G&#46; Spiroulias"
                            2 => "N&#46; Koutsogiannis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Hellenic J Cardiol"
                        "fecha" => "2008"
                        "volumen" => "49"
                        "paginaInicial" => "360"
                        "paginaFinal" => "364"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18846928"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0115"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short-coupled variant of &#8220;torsade de pointes&#8221; and polymorphic ventricular tachycardia"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
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                            1 => "F&#46;C&#46;C&#46; Darrieux"
                            2 => "C&#46;A&#46; Hardy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arq Bras Cardiol"
                        "fecha" => "2014"
                        "volumen" => "102"
                        "paginaInicial" => "e60"
                        "paginaFinal" => "e64"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25004426"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0120"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short-coupled variant of torsade de pointes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "K&#46; Bogaard"
                            1 => "M&#46;S&#46; Steen"
                            2 => "H&#46;L&#46; Tan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neth Heart J"
                        "fecha" => "2008"
                        "volumen" => "16"
                        "paginaInicial" => "246"
                        "paginaFinal" => "249"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18711611"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Electrophysiological characteristic of a patient exhibiting the short-coupled variant of torsade de pointes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46; Shiga"
                            1 => "M&#46; Shoda"
                            2 => "N&#46; Matsuda"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Electrocardiol"
                        "fecha" => "2001"
                        "volumen" => "34"
                        "paginaInicial" => "271"
                        "paginaFinal" => "275"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11455519"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sudden cardiac death and polymorphous ventricular tachycardia in patients with normal QT intervals and normal systolic cardiac function"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46;J&#46; Eisenberg"
                            1 => "M&#46;M&#46; Scheinman"
                            2 => "N&#46;K&#46; Dullet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "1995"
                        "volumen" => "75"
                        "paginaInicial" => "687"
                        "paginaFinal" => "692"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7900661"
                            "web" => "Medline"
                          ]
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                          "pii" => "S1474442213701303"
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                          "issn" => "14744422"
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                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Extracorporeal membrane oxygenation support as bridge to recovery in a patient with electrical storm related cardiogenic shock"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46;E&#46; Brunner"
                            1 => "N&#46; Siegenthaler"
                            2 => "D&#46; Shah"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ajem.2012.08.043"
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                        "tituloSerie" => "Am J Emerg Med"
                        "fecha" => "2013"
                        "volumen" => "31"
                        "paginaInicial" => "467&#46;e1"
                        "paginaFinal" => "467&#46;e6"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23158602"
                            "web" => "Medline"
                          ]
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                          "pii" => "S0090825810004233"
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                          "issn" => "00908258"
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Article information
ISSN: 21742049
Original language: English
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Idiomas
Revista Portuguesa de Cardiologia (English edition)
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