Manifestation of QT Prolongation and Ventricular Fibrillation Associated with Hypokalemia after the Great East Japan Earthquake

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<B>Introduction:</B> On March 11, 2011, Ishinomaki city was the site of an unprecedented earthquake and tsunami disaster. Significant psychological distress was documented across the nation after the great east Japan earthquake. <B>Case report:</B> Three days after the disaster, a 37-year-old woman without any history of ventricular arrhythmia was transported to Ishinomaki Red Cross Hospital due to syncope. She could not eat enough food because of an unavoidable shelter life. In the emergency department, she experienced ventricular fibrillation, which was successfully treated with direct current shock. The twelve-lead ECG on admission revealed sinus bradycardia (48 bpm) and significantly prolonged corrected QT interval (600 ms). The QT prolongation was shortened with restoration of serum potassium and mexiletine administration. Echocardiography showed normal wall motion of the left ventricle. Cardiac catheterization revealed no significant stenosis in the coronary arteries. Propranolol was administrated after a transvenous implantable cardioverter defibrillator (ICD) implantation. No further arrhythmic events occurred during hospitalization. We experienced a case of significant QT prolongation and ventricular fibrillation associated with hypokalemia after the great east Japan earthquake.