Idiopathic Long QT Syndrome With Early Afterdepolarization Induced by Epinephrine : A Case Report

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A patient with idiopathic long QT syndrome had repeated syncopal episodes. The QTc interval on the electrocardiogram at rest was 530ms and was prolonged by exercise up to 740ms with T wave alternation. Intravenous epinephrine (0.1 μg/kg weight per min), but not isoproterenol (0.7μ/min), produced early afterdepolarization of the monophasic action potential recorded at the right ventricular apex. Epinephrine prolonged the QTc interval to 710ms. After the addition of propranolol to the epinephrine, the QTc (580ms) was longer than at baseline. Methoxamine also prolonged the QTc to 580ms. The QT interval in long QT syndrome is generally considered to be prolonged by a β-adrenergic effect, but in the present case α-adrenergic stimulation had an additional effect on the prolongation of the QT interval.
社団法人日本循環器学会の論文
2004-05-20