Pelin KARAASLAN, Cem ERDOĞAN, Arda ÖZYÜKSEL, Kamil DARÇIN, Banu GÖKAY VURAL

Torsade de Pointes during placement of an implantable cardioverter-defibrillator in a child with long QT syndrome

Uzun QT sendromu, Torsade de Pointes başta olmak üzere, ventriküler taşiaritmilere yatkınlığa neden olan, QT aralığında uzama ile karakterizedir. QT aralığının uzamasından inhaler anestetikler sorumlu tutulmaktadır. Bu yazıda, implante edilebilir kardiyoverter-defibrilatör yerleştirme cerrahisi sırasında sevofluran ile genel anestezide iken inatçı Torsade de Pointes atağı geçiren uzun QT sendromlu bir pediatrik olgu sunuldu. Elektriksel kardiyoversiyon gerektiren tekrarlayan Torsade de Pointes ataklarının cerrahi tedavi ile ilişkili olmadığı düşünüldü. Bu ataklar sevofluran inhalasyonu ile ilişkilendirildi. Sevofluran sonlandırıldıktan sonra, aritmiler ortadan kayboldu. Malign aritmiler hastalar için tehlikeli sonuçlar doğurabileceği için, uzun QT sendromlu hastalarda inhaler anestetiklerin kullanılmaması gerektiği kanısındayız.

Uzun QT sendromlu bir çocukta implante edilebilir kardiyoverter-defibrilatör yerleştirilmesi sırasında Torsade de Pointes

Long QT syndrome is characterized by a prolongation of the QT interval resulting in a tendency to ventricular tachyarrhythmias, particularly Torsade de Pointes. Inhalational anesthetics are often accused of prolonged QT interval. Herein, we report a pediatric case of long QT syndrome with a persistent Torsade de Pointes episode under general anesthesia with sevoflurane during surgical implantable cardioverter-defibrillator placement. Recurrent Torsade de Pointes requiring electrical cardioversion were considered to be unrelated to the surgical management. These episodes were considered to be related to sevoflurane inhalation. After terminating sevoflurane, arrhythmias disappeared. As malignant arrhythmias may have detrimental results for patients, we conclude that inhalation anesthetics should be avoided in patients with long QT syndrome.

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