Preoperatif Uzun QT Saptanan Hastaların Demografik ve Klinik Özelliklerinin Retrospektif Değerlendirilmesi

Amaç: Uzun QT sendromu (LQTS) elektrokardiyogramda (EKG) QT intervalinin uzaması ve T dalgaanormallikleri ile prezente olup ventriküler aritmi ataklarına sebep olabilen, nadir görülen ancakmortal seyredebilen sendromdur. Bu hastaların anestezi indüksiyonunda ve idamesinde aritmikkomplikasyonların önlenmesi büyük önem taşımaktadır. Ancak rutin preoperatif değerlendirmedeuzun QT sendromu olan hastaları sıklıkla gözden kaçabilmektedir. Bu çalışmamızda pre-operatifçekilen EKG’ lerde LQTS sıklığını, hastaların demografik özelliklerini ve kardiyoloji konsültasyonla- rı istenme nedenlerini değerlendirdik.Yöntem: 1 Mart 2019-1 Mart 2020 tarihleri arasında hastanemizde elektif operasyon planlananhastaların pre-operatif EKG’leri retrospektif olarak analiz edildi. QTc süresi kadınlarda ≥480 mserkeklerde ≥460 ms olan hastalar LQTS olarak tanımlandı. Bu hastaların protokol numaralarıüzerinden pre-operatif poliklinik notları ve kardiyoloji konsültasyon notları değerlendirildi.Hastaların demografik ve klinik özellikleri analiz edildi.Bulgular: Pre-operatif dönemde çekilen EKG’lerden toplamda 13 kadın 32 erkek olmak üzere 45hastada LQTS saptandı. Çalışmaya alınan hastalardan sadece n=25 (%55.6) hastaya kardiyolojikonsültasyonu istendiği saptandı. Kardiyoloji konsültasyonu istenme sebepleri incelendiğindekonsültasyon istenme sebebinin en sık antiagregan tedavi düzenlenmesi ve ileri yaş nedeniyleedinsel kalp hastalıkları açısından tetkik edilmesi için (n=7, %28 ve n=6, %24) olduğu görüldü.Hiçbir hastaya LQTS nedeni ile kardiyoloji konsültasyonu istenmediği görüldü.Sonuç: Yapılan analizde LQTS saptanan hastalarda kardiyoloji konsültasyonu istenme oranınıngöreceli düşük olduğu, genelde kardiyoloji kliniği tarafından takipli, antiagregan-antikoagulantedavi altında olan, ileri yaşta, efor kapasitesi düşük hastalardan konsültasyon istendiği saptandı.LQTS özellikle dikkat edilmediğinde gözden kaçabilecek bir durum olması nedeniyle bu konudadikkatin artırılmasına ihtiyaç vardır.

Retrospective Evaluation of Demographic and Clinical Features of Patients with Preoperative Long QT Syndrome

Objective: Long QT syndrome (LQTS) is a rarely seen syndrome that may present with prolonged QT interval and T wave abnormalities in the electrocardiogram (ECG) that may cause ventricular arrhythmia attacks and has a mortal course may be presented with. Prevention of arrhythmic com- plications is of great importance in the anaesthesia induction and maintenance of these patients. However, in routine preoperative evaluation, patients with prolonged QT can often be overlooked. In this study of ours, we evaluated the frequency of LQTS, the demographic characteristics of patients, and the reasons for requesting cardiology consultations in the preoperative ECGs. Method: The preoperative ECGs of patients scheduled for elective operation in our hospital between March 1,2019 and March 1,2020 were analysed retrospectively. Patients whose dura- tion of QTc was ≥480 ms in women and ≥460 ms in men were defined as LQTS.Preoperative out- patient clinic data and cardiology consultation were evaluated using the protocol numbers of these patients. The demographic and clinical features of the patients were analysed. Results: Among the ECGs obtained in the pre-operative period, LQTS was detected in 45 patients, 13 women and 32 men. It was found that only n=25(55.6%) patients were requested for cardiol- ogy consultation. When the reasons for the request for cardiology consultation were examined, it was observed that the most frequent indication for consultation was organizing antiaggregant treatment and for examination of acquired heart diseases due to advanced age (n=7, 28% and n=6, 24%, respectively). It was observed that cardiology consultation was not requested for any patient due to LQTS. Conclusion: In the analysis, it was found that the frequency of requesting cardiology consultation was relatively low in patients with LQTS, and consultation was requested for elderly patients with lower exercise capacity under antiplatelet-anticoagulant treatment who were generally followed by the cardiology clinic. Since LQTS is a condition that can be overlooked especially when due attention is not paid, there is a need to increase attention.

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