Focal and Reentrant Mechanisms of Torsades de Pointes: EAD, Reentry, or Chimera?

Abstract

Torsades de pointes (TdP. is characterized not only by its electrocardiographic morphology but also by a tendency to spontaneously terminate. Although clinical and experimental studies suggested that TdP is triggered exclusively by early afterdepolarization, the reentrant mechanism seems to play a certain role in its maintenance. In this article, I review the studies that investigated the origin and activation sequences of the twisting QRS complexes of TdP, and discuss whether it is fortunate or unfortunate for us if TdP has something to do with reentry.

Keywords

• Purkinje network
• Cesium
• Anthopleurin-A
• Polymorphic ventricular tachyarrhythmias
• Spiral wave