Document Detail

Gitelman's syndrome with exercise-induced ventricular tachycardia.
MedLine Citation:
PMID:  15118299     Owner:  NLM     Status:  MEDLINE    
A 62-year-old female with palpitations was admitted to hospital where she recorded 12,299 monofocal ventricular premature contractions (VPCs) in 24 h and nonsustained ventricular tachycardia (VT) on exertion. She had hypokalemia with renal potassium wasting, a chloride-resistant metabolic alkalosis, elevated plasma renin, elevated plasma aldosterone (relative to the serum K concentration), hypomagnesemia with renal magnesium wasting, decreased urine calcium excretion, and normal blood pressure. The hypokalemia and hypomagnesemia were thought to have precipitated the VT. The coronary angiogram showed normal coronary arteries; however, the left ventriculogram revealed akinesis of the posterolateral wall. Because the VT could not be induced by programmed electrical stimulation either before or during intravenous administration of isoproterenol, the VPC with the same QRS morphology as the VT became the target of radiofrequency catheter ablation (RF-CA). Intracardiac mapping showed that the earliest activation site was situated in the asynergic area of the left ventricle (LV) and radiofrequency catheter ablation directed at the LV asynergy area completely eliminated the VPCs without any complications. During the follow-up period (6 months), she was free from palpitation and VT was not clinically documented.
Eisaku Nakane; Tatsuji Kono; Yosio Sasaki; Yasunobu Tokaji; Takahide Ito; Koichi Sohmiya; Yasuhiko Sakai; Michihiro Suwa; Takao Tanaka; Hikaru Nisimura; Yasusi Kitaura
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  68     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-04-30     Completed Date:  2004-11-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  509-11     Citation Subset:  IM    
Third Division, Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
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MeSH Terms
Catheter Ablation*
Hypokalemia / complications*
Magnesium Deficiency / complications*
Middle Aged
Radionuclide Ventriculography
Tachycardia, Ventricular / diagnosis,  etiology*,  therapy*

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