PMC6345081_01
ECG tracing in the emergency room. Sinus rhythm of 100 bpm, QT of 400 ms, and QTc of 516 ms.
omy122f01.jpg
PMC6345081_01_omy122f01.jpg
omy122F1
Electrocardiogram (ECG) in the emergency department displayed a sinus rhythm of 100 bpm, QT interval of 400 ms and QTc of 516 ms (Fig. 1).
ECG tracing before TdP. Sinus rhythm of 83 bpm, QT of 600 ms, and QTc of 707 ms.
omy122f02.jpg
PMC6345081_01_omy122f02.jpg
omy122F2
On the first day after admission, ECG (Fig. 2) in the Department of Respiratory Medicine displayed a sinus rhythm of 83 bpm, QT interval of 600 ms, and QTc interval of 706 ms.
The monitoring electrocardiogram shows that TdP is induced by the short-long cardiac cycles and is followed by an initiating PVC (A). The initiating PVC appears after the T-wave peak of the last beat before the onset of TdP. The red asterisk indicates atrial premature complexes not conducted to the ventricle. However, if the atrial impulse propagates through the atrioventricular node and into the cardiac ventricles, it may induce TdP (B). TdP strip (C).
omy122f03.jpg
PMC6345081_01_omy122f03.jpg
omy122F3
ECG monitoring showed TdP (Fig. 3). Electrical cardioversion was utilized immediately.
ECG tracings at 4 h (A) and 3 days (B) after successful effective cardio-pulmonary resuscitation and electric defibrillation. (A) Sinus rhythm of 68 bpm, QT of 640 ms and QTc of 682 ms. (B) Sinus rhythm of 54 bpm, QT of 680 ms and QTc of 643 ms.
omy122f04.jpg
PMC6345081_01_omy122f04.jpg
omy122F4
In the days after stopping amiodarone, the patient still displayed multiple electrolyte disturbances of hypokalemia and hypocalcemia, and the follow-up ECGs showed prolonged QTc (Fig. 4).