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Figure 1 Sinus Node Dysfunction in the Absence of Drugs Complicated by Torsade de Pointes in a 70-Year-Old Woman
There is extreme sinus bradycardia with a wide-QRS escape rhythm of 32 beats/min. The broad T waves in leads I, II, and aVF were defined as LQT1-like. The triphasic repolarization waves (marked +/–/+ in the first complex) in lead V1 were defined as "bump-sign." The dotted blue lines define the baseline and the return of the T-wave to the baseline, which is the "end of the T-wave" with conventional definitions. Note the late repolarization wave in V1 (the last component of the "bump-sign" marked with a red arrow). Also, note that in lead V1 the first complex of torsade de pointes (double arrow) originates from the very late repolarization wave of the "bump-sign" (arrow) (see text for discussion).
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