A successfully novel ICD implantation and medical treatment in a child with LQT syndrome and self-limiting ventricular fibrillation.
Beta-blocker is the first line drug therapy for congenital long QT syndrome. However, in some children this drug is ineffective. In a non-responder patient, Shimizu et al. used Mexiletine to suppress the ventricular arrhythmias, obtaining a good result. In the high risk patient, the ICD is necessary. However the implantation of a device in small children can have technical problems. We report a case of a child affected by long QT syndrome with recurrent episodes of syncope due to self-limiting torsade de point/ventricular fibrillation, successfully treated by an association of mexiletin and propanolol, and in whom an ICD was implanted with a new subcutaneous approach.
Drago
Fabrizio
F
Fazio
Giovanni
G
Silvetti
Massimo Stefano
MS
Oricchio
Gianluca
G
Michelon
Guido
G
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D003131:Combined Modality Therapy; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D006801:Humans; D008133:Long QT Syndrome / Q000150:complications* / Q000151:congenital*; D008297:Male; D011379:Prognosis; D011433:Propranolol / Q000627:therapeutic use; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*
D000889:Anti-Arrhythmia Agents; D011433:Propranolol