PMC9334073_01
Initial ECG of a 58-year-old man in our hospital. This ECG reveals ST elevations in leads V1-V6 and reciprocal changes in leads II, III, and aVF. ECG: electrocardiogram.
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The initial electrocardiogram (ECG) revealed ST elevations in leads V1-V6 and reciprocal changes in leads II, III, and aVF (Figure 1).
On the fourth day of hospital discharge, the ECG reveals no significant QT prolongation.
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The ECG revealed no significant QT prolongation (Figure 2).
A second ECG taken after ROSC following cardiopulmonary arrest. ECG shows QT prolongation. ECG: electrocardiogram; ROSC: return of spontaneous circulation.
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However, ECG showed QT prolongation (Figure 3).
Polymorphic VT, (a) which starts in a pause-dependent manner with a long-short sequence and (b) is observed frequently after ROSC. Hence, the initial diagnosis is TdP following an MI. VT: ventricular tachycardia; ROSC: return of spontaneous circulation; TdP: torsades de pointes; MI: myocardial infarction.
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Polymorphic VT, which started in a pause-dependent manner with a long-short sequence, was observed frequently (Figures 4(a) and 4(b)).
Repeat ECG following discontinuation of ticagrelor. There is shortening of the previously prolonged QT interval. ECG two days after ticagrelor discontinuation. No further cardiac events are sustained in the follow-up period. ECG: electrocardiogram.
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Subsequently, the QT interval was shortened, and no further TdP occurred (Figure 5).