Key result
Dexmedetomidine-induced bradycardia triggers cardiac arrest via acquired long QT syndrome with QTc reaching 581 ms.
Why the study?
Acquired long QT syndrome can be triggered by various perioperative factors and lead to cardiac arrest, yet its clinical recognition remains challenging.
Case Report (n=1)
No
This case highlights that acquired long QT syndrome can be triggered by perioperative factors during general anesthesia, leading to life-threatening Torsade de Pointes and cardiac arrest.
Dexmedetomidine may trigger acquired long QT syndrome perioperatively; this case leaves open whether routine QTc monitoring is needed in similar procedures.
Background Acquired long QT syndrome (aLQTS) is a disorder of delayed myocardial repolarization induced by medications, electrolyte disturbances, and other factors, with a significantly higher risk in females than in males. Various perioperative factors can trigger aLQTS, which may lead to cardiac arrest in severe cases, yet clinical recognition remains challenging. Case summary This article reports a 38-year-old female patient who underwent laparoscopic combined hysteroscopic tubal lavage under general anesthesia for “bilateral tubal obstruction.” During the procedure, the patient suddenly developed a heart rate of 40 beats per minute, followed by torsade de pointes (TdP) that rapidly progressed to cardiac arrest. The patient was successfully resuscitated after timely cardiopulmonary resuscitation, defibrillation, and pharmacological interventions. Postoperative electrocardiogram and 24-h Holter monitoring showed progressive prolongation of the QTc interval, reaching a maximum of 581 ms. Follow-up electrocardiogram at 1 month post-surgery showed that the QTc interval had returned to normal (421 ms). Based on a review of the literature, the final diagnosis was aLQTS. Conclusion aLQTS is one of the important causes of perioperative cardiac arrest. Female sex, electrolyte disturbances, bradycardia, and QT-prolonging medications can act synergistically as triggers. Comprehensive interventions including early recognition of abnormal electrocardiographic signals, timely resuscitation, and correction of precipitating factors are key to improving prognosis.
No takes yet. Share an insight, caveat, or question.
Wang et al. (2026) conducted a case report in Acquired long QT syndrome (aLQTS) and cardiac arrest (n=1). Perioperative triggers (dexmedetomidine, hypokalemia, bradycardia) was evaluated on Cardiac arrest and QTc interval prolongation. A 38-year-old female developed cardiac arrest due to acquired long QT syndrome triggered by dexmedetomidine-induced bradycardia and electrolyte disturbances during gynecologic laparoscopy, with QTc prolonging to 581 ms before normalizing postoperatively.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: