Ventricular fibrillation after elective surgery in an adolescent with long QT syndrome

Sharon J. Kim, Kavitha N. Pundi, J. Martijn Bos, Michael John Ackerman

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Congenital long QT syndrome (LQTS) is a potentially lethal but highly treatable channelopathy. Along with multiple risk reduction measures, a recommendation for left sympathetic cardiac denervation therapy and/or implantable cardioverter defibrillator is made for higher risk patients. Despite its relatively common incidence in paediatric patients, there are no formal recommendations regarding perioperative management and discharge criteria for LQTS patients undergoing ambulatory surgery. This report describes a 17-year-old girl, diagnosed with congenital LQTS at 9 years of age, who had an episode of ventricular fibrillation the day after elective ear, nose and throat surgery. Despite several risk factors, she had a same-day dismissal, was not adequately monitored postoperatively and her cardiologists were not notified of her procedure. For the high-risk LQTS patient, we recommend monitoring of perioperative electrolytes and rhythm, postoperative ECG, adequate β-blockade therapy, avoidance of particular pharmacological agents, consideration of overnight observation and communication with the patient's cardiologist prior to procedure, and at discharge.

Original languageEnglish (US)
Article numberA1719
JournalBMJ Case Reports
Volume2015
DOIs
StatePublished - Nov 26 2015

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Long QT Syndrome
Ventricular Fibrillation
Channelopathies
Sympathectomy
Implantable Defibrillators
Risk Reduction Behavior
Pharynx
Ambulatory Surgical Procedures
Nose
Electrolytes
Ear
Electrocardiography
Communication
Observation
Pharmacology
Pediatrics
Incidence
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Ventricular fibrillation after elective surgery in an adolescent with long QT syndrome. / Kim, Sharon J.; Pundi, Kavitha N.; Bos, J. Martijn; Ackerman, Michael John.

In: BMJ Case Reports, Vol. 2015, A1719, 26.11.2015.

Research output: Contribution to journalArticle

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