TY - JOUR
T1 - Ventricular ectopy during REM sleep
T2 - Implications for nocturnal sudden cardiac death
AU - Garcia-Touchard, Arturo
AU - Somers, Virend K.
AU - Kara, Tomas
AU - Nykodym, Jiri
AU - Shamsuzzaman, Abu
AU - Lanfranchi, Paola
AU - Ackerman, Michael J.
PY - 2007/5
Y1 - 2007/5
N2 - 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.
AB - 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.
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U2 - 10.1038/ncpcardio0877
DO - 10.1038/ncpcardio0877
M3 - Article
C2 - 17457352
AN - SCOPUS:34247616826
SN - 1743-4297
VL - 4
SP - 284
EP - 288
JO - Nature Clinical Practice Cardiovascular Medicine
JF - Nature Clinical Practice Cardiovascular Medicine
IS - 5
ER -