Key result
Intravenous administration of lidocaine and isoproterenol, along with electrolyte correction, successfully managed repetitive ventricular arrhythmias and hemodynamic deterioration in two patients with preoperative QT interval prolongation undergoing liver transplantation.
Case Report (n=2)
Preoperative recognition of QT interval prolongation and proactive management with lidocaine, isoproterenol, and electrolyte correction are crucial to prevent fatal ventricular arrhythmias during liver transplantation.
May support targeted arrhythmia management in QT-prolonged liver transplant patients; hypothesis-generating and requires prospective validation.
QT interval prolongation is associated with an increased risk of ventricular arrhythmia in various conditions. Cardiac electrophysiologic abnormalities including QT interval prolongation are well documented in patients with advanced liver cirrhosis. We report two cases of patients with QT interval prolongation on preoperative electrocardiography who exhibited repetitive ventricular arrhythmias with significant hemodynamic deterioration during liver transplantation. For the treatment and prevention of ventricular arrhythmias during the intraoperative period, we performed intravenous administration of lidocaine and isoproterenol, corrected imbalances of electrolytes including potassium and magnesium, and prepared a defibrillator. These cases emphasize that preoperative recognition of QT interval prolongation and adequate management to prevent fatal arrhythmias are important in patients undergoing liver transplantation.
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Kim et al. (2014) conducted a case report in Prolonged QT interval during liver transplantation (n=2). Intravenous lidocaine, isoproterenol, and electrolyte correction was evaluated on Resolution of ventricular arrhythmias and hemodynamic instability. Intravenous administration of lidocaine and isoproterenol, along with electrolyte correction, successfully managed repetitive ventricular arrhythmias and hemodynamic deterioration in two patients with preoperative QT interval prolongation undergoing liver transplantation.
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