title: Nifekalant enlarged the transmural activation-recovery interval difference as well as the peak-to-end interval on surface ECG in a patient with short-QT syndrome.
abstract: A 38-year-old woman with type 1 short-QT syndrome (SQTS) was referred to our hospital. Her ECG showed short QT/QTc interval and peaked T wave. Activation-recovery intervals (ARIs) were calculated from the intracardiac endocardial and epicardial electrode catheters placed in the left ventricle (LV). Intravenous administration of nifekalant prolonged effective refractory period at multiple ventricular sites as well as the QT/QTc interval (from 260/300 to 364/419 ms) on the surface ECG. Nifekalant also enlarged the transmural ARI dispersion of the ventricular repolarization, which was measured by the difference between the longest endocardial ARI and the shortest epicardial ARI during atrial pacing at 90 bpm, from 73 to 103-105 ms. These values corresponded to the intervals between the peak and end of the T wave on the surface ECG. Nifekalant-induced QT interval prolongation on the surface ECG may not indicate attenuation of the arrhythmogenic potential in the heart of SQTS patients.
authors.affiliation: School of Health Science, First Department of Internal Medicine, Niigata University School of Medicine, Niigata, Japan. masaomi@clg.niigata-u.ac.jp
authors.forename: Masaomi
authors.initials: M
authors.lastname: Chinushi
authors.forename: Akinori
authors.initials: A
authors.lastname: Sato
authors.forename: Daisuke
authors.initials: D
authors.lastname: Izumi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Furushima
mesh_terms: D000200:Action Potentials; D000293:Adolescent; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D002304:Cardiac Pacing, Artificial; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D017809:Fatal Outcome; D005260:Female; D006329:Heart Conduction System / Q000002:abnormalities / Q000187:drug effects* / Q000503:physiopathology; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D011237:Predictive Value of Tests; D011744:Pyrimidinones / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D011744:Pyrimidinones; C076259:nifekalant