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A neonate with long QT syndrome, refractory ventricular arrhythmias, and lidocaine toxicity

Aruna T Nathan1, Maryam Naim, Lisa M Montenegro

  • 1Department of Anesthesiology & Critical Care Medicine, University of Pennsylvania, Philadelphia, PA, USA. aruna.nathan@gmail.com

Anesthesia and Analgesia
|January 6, 2012
PubMed

Insights

This case study highlights a neonate with compound Long QT syndrome (LQTS) mutations experiencing refractory ventricular tachycardia. Management involved complex pharmacotherapy and ventricular pacing, revealing challenges in neonate LQTS treatment.

Area of Science:

  • Cardiology
  • Genetics
  • Pharmacology

Background:

  • Long QT syndrome (LQTS) presents with ECG changes and ventricular tachycardia risk.
  • Effective management is crucial for neonates, especially symptomatic ones.

Observation:

  • A neonate with compound LQTS mutations exhibited refractory ventricular tachycardia.
  • Treatment included lidocaine, esmolol, amiodarone, and ventricular pacing.

Findings:

  • Complex pharmacokinetic interactions led to presumed lidocaine neurotoxicity, despite normal serum levels.
  • Multimodal therapy presented significant management challenges.

Implications:

  • This case underscores the difficulties in managing neonates with compound LQTS mutations.
  • Understanding drug interactions is vital for optimizing treatment outcomes in pediatric LQTS.

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