title: Endocardial arrhythmogenic mechanisms of torsades de pointes in patients with the congenital long QT syndrome.
abstract: We injected acetylcholine (Ach) into the coronary artery to ascertain whether coronary vasospasm contributed to the syncopal events or chest oppression suffered by 3 patients with long QT syndrome (LQTS). During the test, a quadripolar electrode catheter was placed in the right ventricle and the activation-recovery interval was reanalyzed from the stored data. Intracoronary Ach transiently prolonged the QT intervals in all 3 patients without inducing coronary vasospasm. The Ach-induced QT prolongation was associated with enhanced spatial and temporal dispersion of intra-ventricular repolarization. The electrophysiological abnormalities were consistent with the putative arrhythmogenic mechanisms identified in experimental studies of LQTS.
authors.affiliation: School of Health Science, Niigata University, Japan. masaomi@clg.niigata-u.ac.jp
authors.forename: Masaomi
authors.initials: M
authors.lastname: Chinushi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Furushima
authors.forename: Yukio
authors.initials: Y
authors.lastname: Hosaka
authors.forename: Satoru
authors.initials: S
authors.lastname: Komura
authors.forename: Akinori
authors.initials: A
authors.lastname: Sato
authors.forename: Kenichi
authors.initials: K
authors.lastname: Iijima
authors.forename: Yoshifusa
authors.initials: Y
authors.lastname: Aizawa
mesh_terms: D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000503:physiopathology*; D002648:Child; D004699:Endocardium / Q000002:abnormalities / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008133:Long QT Syndrome / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D016171:Torsades de Pointes / Q000175:diagnosis / Q000503:physiopathology*; D055815:Young Adult