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Korean J Anesthesiol. 2011 Apr;60(4):294-7. doi: 10.4097/kjae.2011.60.4.294. Epub 2011 Apr 26.

Postanesthetic torsade de pointes in a patient with unrecognized long QT syndrome -A case report-.

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  • 1Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Abstract

Torsade de pointes (TdP) is a devastating form of polymorphic ventricular arrhythmia associated with corrected QT (QTc) interval prolongation. TdP usually terminates spontaneously but frequently recurs and may degenerate to ventricular fibrillation. The present report describes a case of TdP in a patient being transferred to the postanesthetic care unit following an emergency laparoscopic appendectomy. The patient had undergone open heart surgery 1 week before. Retrospective electrocardiogram analysis revealed the patient had QTc and Tpeak-Tend interval prolongation that had gone unrecognized. We believe TdP may have been induced by accentuation of sympathetic nervous system during emergence from general anesthesia.

KEYWORDS:

Long QT syndrome; Torsade de pointes; Tpeak-Tend interval; Ventricular fibrillation

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