Ventricular ectopy during REM sleep: Implications for nocturnal sudden cardiac death

Arturo Garcia-Touchard, Virend K. Somers, Tomas Kara, Jiri Nykodym, Abu Shamsuzzaman, Paola Lanfranchi, Michael J. Ackerman

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Background: A young adult female presented with syncope and periodic weakness. A 12-lead electrocardiogram showed frequent premature ventricular contractions and prolonged QU interval. Repetitive runs of nonsustained ventricular tachycardia were recorded at night. Investigations: Electromyography, muscle biopsy, MRI, echocardiography, exercise stress testing using Bruce protocol with microvolt T-wave alternans testing, 24 h Holter monitoring, electrophysiological testing and examination of the effects of sleep and sleep stage on the patient's ventricular arrhythmias. Diagnosis: Type 1 Andersen-Tawil syndrome, (also known as type 7 long QT syndrome). Severe ventricular arrhythmia was observed, predominantly during rapid eye movement sleep. We speculate that the autonomic instability present during rapid eye movement sleep precipitates increasing vulnerability to sleep-related ventricular tachycardia. Management: β-blocker therapy alone, subsequently combined with mexiletine treatment.

Original languageEnglish (US)
Pages (from-to)284-288
Number of pages5
JournalNature Clinical Practice Cardiovascular Medicine
Volume4
Issue number5
DOIs
StatePublished - May 2007

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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