Images in Clinical Medicine
Internal Ventricular Defibrillation
N Engl J Med 2000; 342:398February 10, 2000
- Article
Figure 1 A 12-year-old boy with the familial long-QT syndrome had an automatic cardioverter–defibrillator implanted after resuscitation from cardiac arrest. The device was programmed to wait 7.5 seconds before discharging in response to ventricular tachycardia or ventricular fibrillation. The boy took 120 mg of nadolol daily. Three months later, he suddenly collapsed while answering a question in school. Analysis of the cardioverter–defibrillator revealed the following sequence of events: normal sinus rhythm with a corrected QT interval of 0.66 second (top tracing) was followed by torsade de pointes (middle tracing) and ventricular fibrillation (bottom tracing), prompting discharge of the cardioverter–defibrillator (arrow) and a return to sinus rhythm within 600 msec after discharge. (The rhythm strips are not continuous.) The boy regained full consciousness within two minutes, with no residual neurologic deficits. During the next 15 months, he had no syncope or evidence of recurrent ventricular tachyarrhythmias. Genotypic analysis revealed a mutation in the HERG gene, a gene encoding a potassium channel.
Arthur J. Moss, M.D.
James P. Daubert, M.D.
University of Rochester Medical Center, Rochester, NY 14642- Citing Articles (4)
Citing Articles
1
Maron, Barry J., . (2003) Sudden Death in Young Athletes. New England Journal of Medicine 349:11, 1064-1075
Full Text2
BARRY J. MARON. (2002) Risk Stratification and Prevention of Sudden Death in Hypertrophic Cardiomyopathy. Cardiology in Review 10:3, 173-181
CrossRef3
Barry J. Maron. (2000) Ventricular arrhythmias, sudden death, and prevention in patients with hypertrophic cardiomyopathy. Current Cardiology Reports 2:6, 522-528
CrossRef4
Arthur J. Moss. (2000) Long QT syndromes. Current Treatment Options in Cardiovascular Medicine 2:4, 317-321
CrossRef
