Summary
Case description of a 30 year-old woman with recurrent attacks of symptomatic ventricular tachyarrhythmias but without Q-T prolongation in the electrocardiogram. All conventional antiarrhythmic agents failed to suppress the arrhythmia and electrical defibrillation had to be carried out 99 times. Blockade of the left stellate ganglion with lidocaine followed by stellectomy led to successful control of the dangerous rhythm disturbance for a follow-up period of 1.5 years. As in patients with the classical long Q-T syndrome stellate ganglion blockade and stellectomy might be indicated in cases with the so called latent Q-T syndrome and life threatening ventricular arrhythmias resistant to antiarrhythmic agents.
Zusammenfassung
Es wird über den Fall eines latenten QT-Syndroms berichtet mit recidivierenden Attacken von Kammerflimmern ohne wesentliche QT-Verbreiterung im Elektrokardiogramm. Die Patientin war resistent gegen die üblichen Antiarrhythmika und mußte 99mal defibrilliert werden. Erst die Stellatum-Blockade mit anschließender Stellektomie führte zur Anfallsfreiheit über einen Zeitraum von jetzt 1 1/2 Jahren. Ähnlich wie beim klassischen QT-Syndrom ist deshalb bei recidivierendem Kammerflimmern die probatorische Stellatum-Blockade mit Injektion von Lidocain und bei Erfolg eine Stellektomie angezeigt, wenn Verdacht auf ein latentes QT-Syndrom besteht und andere Ursachen ausgeschlossen sind.
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Literatur
Abbildskov JA (1979) The prolonged Q-T-interval. Am Rev Med 30:71–79
Burgess MJ, Millar K, Abildskov JA (1969) Cancellation of electrocardiographic effects during ventricular recovery. J Electrocardiol 2:101–108
Crampton R (1979) Preeminence of the left stellate ganglion in the long Q-T syndrome. Circulation 59:769–778
Engel TR, Meister SG, Frankl WS (1978) The R-on-T phenomenon. Ann Int Med 88:221–225
Froggat P, James TN (1973) Sudden unexpected death in infants. Evidence on a lethal cardiac arrhythmia. Ulster Med J 42:136–152
Freen JR, Korovetz MJ, Shanklin DR, DeVito JJ, Taylor WJ (1969) Sudden unexpected death in three generations. Arch Intern Med 124:359–363
Jervell A, Lange-Nielsen F (1957) Congenital deaf-mutism, functional heart diesease, with prolongation of the QT interval and sudden death. Am Heart J 54:59–68
McRae JR, Wagner GS, Rogers MC, Canlict RV (1974) Paroxysmal familial ventricular fibrillation. J Pediatr 84:515–518
Moss JA, MacDonald J (1971) Unilateral cervicothoracic sympathetic ganglionectomy for the treatment of QT interval syndrome. N Engl J Med 285:903–904
Moss AJ, Schwartz PJ (1979) Sudden death and the idiopathic long Q-T syndrome. Am J Med 66:6–7
Romano C, Gemme G, Pongiglione R (1963) Aritmie cardiache rare dellétà pediatrica. Clin Pediatr 45:658–683
Schwartz PJ, Malliani A (1975) Electrical alternation of the T-wave: Clinical and experimental evidence of its relationship with the sympathetic nervoussystem and with the long Q-T syndrome. Am Heart J 89:45–50
Schwartz PJ, Periti M, Malliani A (1975) The long QT-Syndrome. Am Heart J 89:378–390
Schwartz PJ, Stone HL (1978) Unilateral stellectomy and sudden death. Neural Mechanism in cardiac arrhythmias. Schwartz PJ, Brown AM, Malliani A, Zanchetti A (eds). Raven Press, New York, p 107
Schwartz PJ (1978) Experimental reproduction of the long Q-T syndrome. Am J Cardiol 33:174
Vincent GM, Abildskov JA, Burgess MJ, Millar K (1974) Anatomic manipulation in the inherited long Q-T recurrent syncope syndrome. Am J Cardiol 33:174
Ward DC (1964) New familial cardiac syndrome in children. J Irish Med Assoc 54:103–106
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Schoeneberger, A., Bamberg, E. & Bussmann, W.D. QT-Syndrom ohne QT-Verlängerung. Klin Wochenschr 59, 281–285 (1981). https://doi.org/10.1007/BF01478207
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DOI: https://doi.org/10.1007/BF01478207