Degenerating Regenerating Torsades de Pointes


  • Grants and Financial Support: M.J. Perrin, M.H. Gollob, P.B. Nery, A. Keren: None; D.H. Birnie: Speaker honoraria Medtronic, and research support from Medtronic and Boston Scientific.

Address for reprints: Mark Perrin, M.B.B.S., Ph.D., Ottawa Heart Institute, University of Ottawa, 40 Ruskin Street, Ottawa, ON, K1Y4W7, Canada. Fax: 1 613 761 4549; e-mail:


Ventricular fibrillation (VF) commonly ends in death. Isolated case reports describe the uncommon occurrence of spontaneous termination of VF. Torsades de pointes (TdP), a peculiar form of polymorphic ventricular tachycardia associated with a prolonged QT interval on the surface electrocardiogram, most often spontaneously terminates and then returns to the underlying rhythm. Here, we present an unusual case of TdP degenerating into VF, reorganizing into TdP, and then spontaneously terminating. Our case suggests that the mechanisms underlying the maintenance of TdP and VF are not dissimilar. The precipitants to this event and the likely mechanisms operative are discussed.