title: Asymptomatic idiopathic syndrome of prolonged Q-T interval in a 45-year-old woman. Ventricular tachyarrhythmias precipitated by hypokalemia and therapy with amitriptyline and prephenazine.
abstract: Recurrent ventricular tachyarrhythmias required multiple resuscitative efforts with electrical countershock in a 45-year-old woman with previously undiagnosed asymptomatic congenital prolongation of the Q-T interval. This patient represents the oldest person with symptoms relating to idiopathic prolongation of the Q-T interval found in the literature. Exacerbating factors, including diuretic-induced hypokalemia and the concomitant administration of perphenazine, were present. In such cases, initially refractory to therapy with antiarrhythmic agents, insertion of a transvenous pacemaker with overdrive suppression of the ventricular tachyarrhythmias may be lifesaving, allowing for the institution of therapy with agents that can selectively shorten the Q-T interval.
mesh_terms: D000639:Amitriptyline / Q000009:adverse effects*; D001950:Bretylium Tosylate / Q000627:therapeutic use; D004562:Electrocardiography; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D007008:Hypokalemia / Q000150:complications*; D008875:Middle Aged; D010546:Perphenazine / Q000009:adverse effects*; D010672:Phenytoin / Q000627:therapeutic use; D011433:Propranolol / Q000627:therapeutic use; D013575:Syncope / Q000139:chemically induced / Q000150:complications; D013577:Syndrome; D013610:Tachycardia / Q000150:complications / Q000188:drug therapy / Q000209:etiology*
chemical_list: D000639:Amitriptyline; D010672:Phenytoin; D001950:Bretylium Tosylate; D011433:Propranolol; D010546:Perphenazine