Landiolol suppression of electrical storm of torsades de pointes in patients with congenital long-QT syndrome type 2 and myocardial ischemia

Ryota Kitajima, MD; Takeshi Aiba, MD; Tsukasa Kamakura, MD; Kohei Ishibashi, MD; Mitsuru Wada, MD; Yuko Inoue, MD; Koji Miyamoto, MD; Hideo Okamura, MD; Takashi Noda, MD; Satoshi Nagase, MD; Yu Kataoka, MD; Yasuhide Asaumi, MD; Teruo Noguchi, MD; Satoshi Yasuda, MD; Kengo Kusano, MD

doi:10.1016/j.joa.2017.05.007

Journal of Arrhythmia (Oct 2017)

Landiolol suppression of electrical storm of torsades de pointes in patients with congenital long-QT syndrome type 2 and myocardial ischemia

Ryota Kitajima, MD,
Takeshi Aiba, MD,
Tsukasa Kamakura, MD,
Kohei Ishibashi, MD,
Mitsuru Wada, MD,
Yuko Inoue, MD,
Koji Miyamoto, MD,
Hideo Okamura, MD,
Takashi Noda, MD,
Satoshi Nagase, MD,
Yu Kataoka, MD,
Yasuhide Asaumi, MD,
Teruo Noguchi, MD,
Satoshi Yasuda, MD,
Kengo Kusano, MD

Affiliations

Ryota Kitajima, MD: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Takeshi Aiba, MD: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Tsukasa Kamakura, MD: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Kohei Ishibashi, MD: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Mitsuru Wada, MD: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Yuko Inoue, MD: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Koji Miyamoto, MD: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Hideo Okamura, MD: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Takashi Noda, MD: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Satoshi Nagase, MD: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Yu Kataoka, MD: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Yasuhide Asaumi, MD: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Teruo Noguchi, MD: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Satoshi Yasuda, MD: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Kengo Kusano, MD: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan

DOI: https://doi.org/10.1016/j.joa.2017.05.007
Journal volume & issue: Vol. 33, no. 5
pp. 501 – 504

Abstract

Read online

A 76-year-old man who had been diagnosed with long-QT syndrome type 2 had frequent syncopal attacks. The electrocardiogram was monitored, and frequent torsades de pointes (TdP) was detected despite administration of conventional medications: oral propranolol, verapamil, intravenous magnesium sulfate, verapamil, and lidocaine. In contrast, 2 μg/kg/min landiolol could completely suppress TdP. Subsequently, an implantable cardioverter defibrillator was placed, and he was diagnosed with silent myocardial ischemia using myocardial perfusion scintigraphy and coronary angiography. This is the first case report wherein landiolol effectively suppressed TdP due to long-QT syndrome with silent myocardial ischemia.

Published in Journal of Arrhythmia

ISSN: 1880-4276 (Print); 1883-2148 (Online)
Publisher: Wiley
Country of publisher: Australia
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://onlinelibrary.wiley.com/journal/18832148

About the journal

Abstract

Keywords