Would you consider overdrive pacing for recurrent torsades des pointes in a patient without an obvious drug causing QTc prolongation or significant electrolyte abnormality?

Overdrive pacing is a guideline-recommended treatment for recurrent torsade de pointes in the setting of prolonged QT interval, particularly for patients with bradycardia exacerbating the QT prolongation. Isoproterenol infusion is another option to treat these patients. In these patients, the overdrive pacing might help shorten the QT interval and reduce the inciting PVCs. In the absence of any QT prolongation, it is unlikely that the patient is having true torsade de pointes and is more likely ...

I agree with most of Dr. @Dr. First Last's commentary with the following addition:

The mechanism of torsade de pointes (TdP) in Long QT syndrome is early after-depolarization (EAD) mediated triggered activity, which typically occurs during underlying slow heart rates. The goal of overdrive pacing is to overcome this scenario.

TdP occurring in the absence of QT prolongation is quite rare (short-coupled VF and some cases of Brugada syndrome). I am not aware of any data that shows overdrive pacing ...