Key result
Sevoflurane anesthesia prolonged the QTc interval from 631 ms to 727 ms and the Tp-e interval from 126 ms to 222 ms in a 16-year-old male with long QT syndrome type 3.
Why the study?
Does sevoflurane prolong QTc and Tp-e intervals in a patient with long QT syndrome type 3?
Case Report (n=1)
No
Does sevoflurane prolong QTc and Tp-e intervals in a patient with long QT syndrome type 3?
Absolute Event Rate: 727% vs 631%
Sevoflurane can cause marked QTc and Tp-e interval prolongation in poorly controlled LQT3 patients, suggesting it should be avoided in this population to prevent lethal arrhythmias.
Suggests avoiding sevoflurane in poorly controlled LQT3 to prevent lethal arrhythmias; leaves open.
We report that sevoflurane not only caused marked QTc interval prolongation but also increased transmural dispersion of repolarization in a patient with long QT syndrome 3 (LQT3). A 16-year-old male with LQT3 underwent a shoulder operation. He experienced no episode of syncope or cardiac arrest, but his preoperative electrocardiography (ECG) showed marked QTc interval prolongation (631 ms) and Tp-e interval prolongation (126 ms). Anesthesia was induced with propofol and maintained with 2% sevoflurane and remifentanil. Although no lethal arrhythmias occurred in the perioperative period, not only the QTc interval but also Tp-e interval was further prolonged by sevoflurane. While sevoflurane has been recognized as a safe anesthetic in terms of QT interval prolongation, even in patients with long QT syndromes, we believe that sevoflurane might be avoided for poorly controlled LQT3 patients.
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Kitaura et al. (2017) conducted a case report in Long QT syndrome type 3 (LQT3) (n=1). Sevoflurane vs. Pre-anesthetic baseline was evaluated on QTc interval prolongation (ms). Sevoflurane anesthesia prolonged the QTc interval from 631 ms to 727 ms and the Tp-e interval from 126 ms to 222 ms in a 16-year-old male with long QT syndrome type 3.
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