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Background:   Cardiac surgery injures the impulse formation and conduction system. Total atrioventricular block has been reported in patients requiring valve repair procedure. Polymorphic ventricular tachycardia after cardiac surgery is uncommon and little-studied, but some cases of polymorphic ventricular tachycardia have been reported.
            Case Report:  We report the case of a 54-year-old woman with severe mitral regurgitation and atrial fibrillation with rapid ventricular response, who developed nodal escape rhythm following mitral valve surgery treated by temporary ventricular pacing. In the ECG obtained upon cessation of pacing, nodal escape rhythm at 60/min and prolonged QT interval to 600 ms were present. During this ECG recording, non-sustained polymorphic ventricular tachycardia occurred. The atrial fibrillation returned on the third day and converted spontaneously into sinus rhythm on the seventh day after cardiac surgery.
            Conclusions:   Our case indicates that inadequate rate control before cardiac surgery (high heart rate) may predispose to ventricular tachyarrhythmias after the procedure, complicated with bradyarrhythmia.

Keywords: polymorphic wide-QRS complex tachycardia, bradyarrhythmia, cardiac surgery,