Torsade de Pointes during placement of an implantable cardioverter-defibrillator in a child with long QT syndrome

Banu Vural Gökay,

doi:10.5606/tgkdc.dergisi.2016.12323

Banu Vural Gökay¹, Pelin Karaaslan², Cem Erdoğan², Kamil Darçın², Arda Özyüksel³

¹Department of Anesthesiology and Reanimation, Acıbadem University Atakent Hospital, İstanbul, Turkey
²Departments of Anesthesiology and Reanimation, İstanbul Medipol University Hospital, İstanbul, Turkey
³Departments of Cardiovascular Surgery, İstanbul Medipol University Hospital, İstanbul, Turkey

DOI : 10.5606/tgkdc.dergisi.2016.12323

Long QT syndrome is characterized by a prolongation of the QT interval resulting in a tendency to ventricular tachyarrhythmias, particularly Torsade de Pointes. Inhalational anesthetics are often accused of prolonged QT interval. Herein, we report a pediatric case of long QT syndrome with a persistent Torsade de Pointes episode under general anesthesia with sevoflurane during surgical implantable cardioverter-defibrillator placement. Recurrent Torsade de Pointes requiring electrical cardioversion were considered to be unrelated to the surgical management. These episodes were considered to be related to sevoflurane inhalation. After terminating sevoflurane, arrhythmias disappeared. As malignant arrhythmias may have detrimental results for patients, we conclude that inhalation anesthetics should be avoided in patients with long QT syndrome.

Keywords : Arrhythmia; long QT syndrome; sevoflurane

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