Sudden Death During Holter Monitoring
Report:
Supraventricular and ventricular bigeminy
Prolonged QT interval (0.64â)
Multiform, probably torsade de pointes, ventricular tachycardia
Comment:
This patient was on digoxin and quinidine. The final (and fatal) paroxysm is initiated by a late VEB; the tachycardia appears to be a true torsade de pointes142.
An episode of definite repolarisation alternans (Fig 198a) preceded the torsade.
198a. T wave alternans.
199. 56 year old alcoholic on alphamethyldopa, chlorothiazide and (too little or too much?) potassium supplements
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