Does an implantable automatic cardioverter-defibrillator effectively recognize and terminate ventricular tachyarrhythmias in patients with prolonged QT syndrome?
Implantation of an automatic cardioverter-defibrillator effectively recognizes and terminates induced ventricular arrhythmias in patients with prolonged QT syndrome, suggesting it as a viable adjunct to antiarrhythmic therapy.
Two patients with the prolonged QT syndrome and recurrent ventricular tachyarrhythmias are presented, one of them refractory to combination antiarrhythmic drug therapy and bilateral stellate ganglion blockade. We implanted and tested in vivo an automatic cardioverter-defibrillator to provide a cardiac monitoring system with the capability of delivering a 25 J electrical discharge to the heart if rapid ventricular tachycardia or ventricular fibrillation is detected. Arrhythmia induction in the electrophysiology laboratory confirmed the appropriate recognition of the arrhythmias in each patient, with prompt discharge of the device and resultant termination of the tachycardias. We suggest that implantation of such a device may provide an effective adjunct to antiarrhythmic drug therapy in the management of infrequent, but potentially lethal, ventricular arrhythmias occurring in patients with the prolonged QT syndrome.
Platia et al. (Sun,) studied this question.