title: Ventricular ectopy during REM sleep: implications for nocturnal sudden cardiac death.
abstract: 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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  Beta-blocker therapy alone, subsequently combined with mexiletine treatment.
authors: Mayo Clinic College of Medicine in Rochester, Minnesota 55905, USA.
authors: Arturo
authors: A
authors: Garcia-Touchard
authors: Virend K
authors: VK
authors: Somers
authors: Tomas
authors: T
authors: Kara
authors: Jiri
authors: J
authors: Nykodym
authors: Abu
authors: A
authors: Shamsuzzaman
authors: Paola
authors: P
authors: Lanfranchi
authors: Michael J
authors: MJ
authors: Ackerman
mesh_terms: D000293:Adolescent; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001706:Biopsy; D016757:Death, Sudden, Cardiac / Q000209:etiology* / Q000517:prevention & control; D003937:Diagnosis, Differential; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D004576:Electromyography; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008801:Mexiletine / Q000627:therapeutic use; D018482:Muscle, Skeletal / Q000473:pathology / Q000503:physiopathology; D017286:Polysomnography; D012895:Sleep, REM / Q000502:physiology*; D018879:Ventricular Premature Complexes / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology
chemical_list: D000889:Anti-Arrhythmia Agents; D008801:Mexiletine