In patients with abnormal repolarization, the ventricular myocardium may be unduly sensitive to sympathetic stimuli, resulting in ventricular tachyarrhythmias that can be suppressed by beta-blockers.
Beta-blockers may suppress sympathetic-triggered ventricular ectopy in abnormal repolarization; this case leaves open confirmation in prospective studies.
SUMMARY Tachyarrhythmic Adams‐Stokes attacks, provoked by physical and emotional stress, are reported in a 10‐year‐old girl with sinus brady‐cardia at rest, prominent U waves, a normal resting QT‐interval but QT‐prolongation on exercise. Two brothers, the father and the paternal grandmother have a slight QT‐prolongation but no attacks. In the proband, physical exercise and small doses of a beta‐adrenergic stimulator reliably cause ventricular bigemini and/or runs of multifocal ventricular extra‐systoles while increase in heart rate by Atropine and atrial pacing does not. The ventricular arrhythmia is improved by beta‐receptor blocking agents. It is proposed that in this and other patients with abnormal repolarization the ventricular myocardium is unduely sensitive to sympathetic stimuli, resulting in ventricular tachyarrhythmia.
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Bernuth et al. (1973) studied this question.
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