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Titolo:
Pause-dependent torsade de pointes following acute myocardial infarction -A variant of the acquired long QT syndrome
Autore:
Halkin, A; Roth, A; Lurie, I; Fish, R; Belhassen, B; Viskin, S;
Indirizzi:
Tel Aviv Med Ctr & Sch Med, Dept Cardiol, IL-64239 Tel Aviv, Israel Tel Aviv Med Ctr & Sch Med Tel Aviv Israel IL-64239 239 Tel Aviv, Israel Tel Aviv Univ, Sackler Sch Med, IL-69978 Tel Aviv, Israel Tel Aviv Univ Tel Aviv Israel IL-69978 ch Med, IL-69978 Tel Aviv, Israel
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 4, volume: 38, anno: 2001,
pagine: 1168 - 1174
SICI:
0735-1097(200110)38:4<1168:PTDPFA>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
POLYMORPHOUS VENTRICULAR-TACHYCARDIA; Q-T INTERVAL; DE-POINTES; CORONARY-ARTERY; TRIGGERED ACTIVITY; TIME COURSE; ARRHYTHMIAS; AFTERDEPOLARIZATIONS; PROLONGATION; MORTALITY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
38
Recensione:
Indirizzi per estratti:
Indirizzo: Viskin, S Tel Aviv Med Ctr & Sch Med, Dept Cardiol, 6 Weizman St, IL-64239Tel Aviv,Israel Tel Aviv Med Ctr & Sch Med 6 Weizman St Tel Aviv Israel IL-64239
Citazione:
A. Halkin et al., "Pause-dependent torsade de pointes following acute myocardial infarction -A variant of the acquired long QT syndrome", J AM COL C, 38(4), 2001, pp. 1168-1174

Abstract

OBJECTIVES We report on a previously unrecognized form of the long QT syndrome QT interval prolongation and pause-dependent polymorphic ventricular tachycardia [VT]) entirely related to myocardial infarction (MI). BACKGROUND Polymorphic VT in the setting of acute MI generally occurs during the hyperacute phase, is related to ischemia, and is not associated withQT prolongation. Although QT prolongation after MI is well described, typical pause-dependent polymorphic VT (torsade de pointes) secondary to uncomplicated MI was previously unknown. prolongation that. METHODS Of 434 consecutive admissions for acute MI, 8 patients had progressive QT led to typical torsade de pointes. None of these patients had active ischemia or other known causes of QT prolongation. These patients were compared with 100 consecutive patients with uncomplicated MI who served as controls. RESULTS The incidence of torsade de pointes following MI was 1.8% (95% confidence interval 0.8% to 3.6%). The QTc intervals of patients and controls were similar on admission. The QTc lengthened by day 2 in both groups, but more so in patients with torsade de pointes (from 470 +/- 46 to 492 +/- 57 ms [p < 0.051] and from 445 +/- 58 to 558 +/- 84 ms, respectively [p < 0.01]). Maximal QT prolongation and torsade de pointes occurred 3 to 11 days after infarction. Therapy included defibrillation, magnesium, lidocaine and beta-blockers. Three patients required rapid cardiac pacing. The long-term course was uneventful. CONCLUSIONS Infarct-related torsade de pointes is uncommon but potentiallylethal. An acquired long QT syndrome should be considered in patients recovering from MI who experience polymorphic Was specific therapeutic measuresare mandatory. (C) 2001 by the American College of Cardiology.

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Documento generato il 02/04/20 alle ore 00:26:40