PDF(Pubmed)
Abstract：
Torsades de Pointes (TdP) is a malignant polymorphic ventricular tachycardia with heart rate corrected QT interval (QTc) prolongation, which may be attributed to congenital and acquired factors. Although various acquired factors for TdP have been summarized, levosimendan administration in complex postoperative settings is relatively uncommon. Timely identification of potential causes and appropriate management may improve the outcome. Herein, we describe the postoperative case of a 56-year-old female with initial normal QTc who accepted the administration of levosimendan for heart failure, suffered TdP, cardiac arrest, and possible Takotsubo cardiomyopathy, further genetically confirmed as long QT syndrome type 1 (LQT1). The patient was successfully treated with magnesium sulfate, atenolol, and implantable cardioverter defibrillator implantation. There should be a careful evaluation of the at-risk populations and close monitoring of the electrocardiograms, particularly the QT interval, to reduce the risk of near-fatal arrhythmias during the use of levosimendan.
摘要：
扭转点（TdP）是一种恶性多形性室性心动过速，具有心率校正的QT间期（QTc）延长，这可能归因于先天和后天因素。尽管已经总结了TdP的各种获得因素，在复杂的术后环境中，左西孟旦给药相对少见。及时发现潜在的原因和适当的管理可以改善结果。在这里，我们描述了一名最初QTc正常的56岁女性患者的术后病例，该患者接受左西孟旦治疗心力衰竭，遭受TdP,心脏骤停,和可能的Takotsubo心肌病，进一步遗传证实为长QT综合征1型（LQT1）。病人用硫酸镁治疗成功,阿替洛尔,和植入式心律转复除颤器植入。应仔细评估高危人群,密切监测心电图,特别是QT间隔，降低使用左西孟旦期间发生近乎致命的心律失常的风险。
