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Survival Following Spontaneous Ventricular Flutter-Fibrillation Associated With QT Syndrome: Documentation During Ambulatory Monitoring

Survival Following Spontaneous Ventricular Flutter-Fibrillation Associated With QT Syndrome:... Abstract A 56-year-old woman complaining of recurrent syncope was admitted to the coronary care unit after a fainting episode. Three days of continuous monitoring indicated prolongation of the QT interval and occasional premature ventricular beats. After transfer to another hospital wing, the patient was given ambulatory status. On the fifth day, while wearing a Holter monitor recorder, the patient lost consciousness. Review of the ambulatory ECG demonstrated multiple premature ventricular beats and an episode of paroxysmal ventricular flutter-fibrillation. The ventricular arrhythmias were correlated with telephone calls. It is concluded that (1) prolonged monitoring be performed in such subjects, and (2) the absence of ventricular tachyarrhythmias on repeated ECG recording should not preclude pharmacologic intervention in patients with the prolonged QT interval syndrome, ventricular ectopy, and a history of recurrent syncope. (Arch Intern Med 140:255-256, 1980) References 1. Gradman AH, Bell PA, Debusk RF: Sudden death during ambulatory monitoring: Clinical and electrocardiographic correlations: Report of a case. Circulation 55:210-211, 1977.Crossref 2. Hinkle LE, Argyros DC, Hayes JC, et al: Pathogenesis of an unexpected sudden death: Role of early cycle ventricular premature contractions. Am J Cardiol 39:873-879, 1977.Crossref 3. Lown B, Verrier RL, Rabinowitz SH: Neural and psychologic mechanisms and the problem of sudden cardiac death. Am J Cardiol 39:890-902, 1977.Crossref 4. Lown B, DeSilva RA: Roles of psychologic stress and autonomic nervous system changes in provocation of ventricular premature complexes. Am J Cardiol 41:979-985, 1978.Crossref 5. Lown B, Temte JV, Reich P, et al: Basis for recurring ventricular fibrillation in the absence of coronary heart disease and its management. N Engl J Med 294:623-629, 1976.Crossref 6. Vincent GM, Abildskov JA, Burgess MJ: Q-T interval syndromes. Prog Cardiovasc Dis 16:523-530, 1974.Crossref 7. Schwartz PJ, Periti M, Malliani A: The long Q-T syndrome. Am Heart J 89:378-390, 1975.Crossref 8. Karhunen P, Luomanmaki K, Heikkila J, et al: Syncope and Q-T prolongation without deafness: The Romano-Ward syndrome. Am Heart J 80:820-823, 1970.Crossref 9. Moss AJ, McDonald J: Unilateral cervicothoracic sympathetic gangionectomy for the treatment of long QT interval syndrome. N Engl J Med 285:903-904, 1971.Crossref 10. Ratshin RA, Hunt D, Russell RO, et al: QT-interval prolongation, paroxysmal ventricular arrhythmias, and convulsive syncope. Ann Intern Med 75:919-924, 1971.Crossref 11. Wellens HJJ, Vermeulen A, Durrer D: Ventricular fibrillation occurring on arousal from sleep by auditory stimuli. Circulation 46:661-665, 1972.Crossref 12. Krikler DM, Curry PVL: Torsade de pointes, an atypical ventricular tachycardia, editorial. Br Heart J 38:117-120, 1976.Crossref 13. Krikler DM, Curry PVL, Evans TR: Torsade de pointes: An atypical ventricular tachycardia, abstracted. Br Heart J 38:311, 1976.Crossref 14. Schwartz PJ, Malliani A: Electrical alternation of the T-wave: Clinical and experimental evidence of its relationship with the sympathetic nervous system and with the long Q-T syndrome. Am Heart J 89:45-50, 1975.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Survival Following Spontaneous Ventricular Flutter-Fibrillation Associated With QT Syndrome: Documentation During Ambulatory Monitoring

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References (16)

Publisher
American Medical Association
Copyright
Copyright © 1980 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1980.00330140113028
Publisher site
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Abstract

Abstract A 56-year-old woman complaining of recurrent syncope was admitted to the coronary care unit after a fainting episode. Three days of continuous monitoring indicated prolongation of the QT interval and occasional premature ventricular beats. After transfer to another hospital wing, the patient was given ambulatory status. On the fifth day, while wearing a Holter monitor recorder, the patient lost consciousness. Review of the ambulatory ECG demonstrated multiple premature ventricular beats and an episode of paroxysmal ventricular flutter-fibrillation. The ventricular arrhythmias were correlated with telephone calls. It is concluded that (1) prolonged monitoring be performed in such subjects, and (2) the absence of ventricular tachyarrhythmias on repeated ECG recording should not preclude pharmacologic intervention in patients with the prolonged QT interval syndrome, ventricular ectopy, and a history of recurrent syncope. (Arch Intern Med 140:255-256, 1980) References 1. Gradman AH, Bell PA, Debusk RF: Sudden death during ambulatory monitoring: Clinical and electrocardiographic correlations: Report of a case. Circulation 55:210-211, 1977.Crossref 2. Hinkle LE, Argyros DC, Hayes JC, et al: Pathogenesis of an unexpected sudden death: Role of early cycle ventricular premature contractions. Am J Cardiol 39:873-879, 1977.Crossref 3. Lown B, Verrier RL, Rabinowitz SH: Neural and psychologic mechanisms and the problem of sudden cardiac death. Am J Cardiol 39:890-902, 1977.Crossref 4. Lown B, DeSilva RA: Roles of psychologic stress and autonomic nervous system changes in provocation of ventricular premature complexes. Am J Cardiol 41:979-985, 1978.Crossref 5. Lown B, Temte JV, Reich P, et al: Basis for recurring ventricular fibrillation in the absence of coronary heart disease and its management. N Engl J Med 294:623-629, 1976.Crossref 6. Vincent GM, Abildskov JA, Burgess MJ: Q-T interval syndromes. Prog Cardiovasc Dis 16:523-530, 1974.Crossref 7. Schwartz PJ, Periti M, Malliani A: The long Q-T syndrome. Am Heart J 89:378-390, 1975.Crossref 8. Karhunen P, Luomanmaki K, Heikkila J, et al: Syncope and Q-T prolongation without deafness: The Romano-Ward syndrome. Am Heart J 80:820-823, 1970.Crossref 9. Moss AJ, McDonald J: Unilateral cervicothoracic sympathetic gangionectomy for the treatment of long QT interval syndrome. N Engl J Med 285:903-904, 1971.Crossref 10. Ratshin RA, Hunt D, Russell RO, et al: QT-interval prolongation, paroxysmal ventricular arrhythmias, and convulsive syncope. Ann Intern Med 75:919-924, 1971.Crossref 11. Wellens HJJ, Vermeulen A, Durrer D: Ventricular fibrillation occurring on arousal from sleep by auditory stimuli. Circulation 46:661-665, 1972.Crossref 12. Krikler DM, Curry PVL: Torsade de pointes, an atypical ventricular tachycardia, editorial. Br Heart J 38:117-120, 1976.Crossref 13. Krikler DM, Curry PVL, Evans TR: Torsade de pointes: An atypical ventricular tachycardia, abstracted. Br Heart J 38:311, 1976.Crossref 14. Schwartz PJ, Malliani A: Electrical alternation of the T-wave: Clinical and experimental evidence of its relationship with the sympathetic nervous system and with the long Q-T syndrome. Am Heart J 89:45-50, 1975.Crossref

Journal

Archives of Internal Medicine – American Medical Association

Published: Feb 1, 1980

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