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Two Cases of LQT Syndrome with Malignant Syncope after Switch from Propranolol to Bisoprolol
Milos Kesek1, Annika Rydberg2, Steen M Jensen1
1Heart Centre, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Abstract:
Propranolol in slow-release form has been the first-line treatment in long QT (LQT) until it was withdrawn from the market. We describe two cases where a switch to bisoprolol resulted in worsening of arrhythmia control: A man with LQT2, asymptomatic on propranolol, experienced syncope after switching to bisoprolol 5 mg daily. He switched back to propranolol and has remained asymptomatic during subsequent 12 months. A man with classical Jervell Lange-Nielsen syndrome, previous gangliectomy, and ICD implantation, switched to bisoprolol 5 mg daily. Four months later he experienced a tachycardia storm. He switched back to propranolol and has remained free from arrhythmias during subsequent 12 months.
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