| Long QT syndrome due to a novel mutation in SCN5A: treatment with ICD placement at 1 month and left cardiac sympathetic denervation at 3 months of age. | |
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MedLine Citation:
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PMID: 19669871 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We describe the case of a newborn with congenital long QT syndrome, with 2:1 AV block and frequent episodes of Torsades de Pointes (TdP) requiring placement of a dual chamber ICD at 33 days and 3.63 kg, the youngest and smallest patient, thus far reported. Long QT syndrome was diagnosed due to bradycardia in the newborn nursery, with frequent episodes of TdP. The patient was initially treated with magnesium and esmolol then given lidocaine which resulted in dramatic transient normalization of the QTc with 1:1 AV nodal conduction. An attempt to transition to oral sodium channel and beta blockade was unsuccessful. An ICD was placed and dual chamber pacing was initiated which facilitated the transition to an oral medical regimen and ultimate discharge from the hospital. Soon after placement of the ICD, genetic testing revealed a novel F1473C mutation in the SCN5A gene. Episodes of TdP continued and left stellate gangliectomy was performed at 3 months of age. At 30 months follow-up, the patient has occasional, self-limited episodes of TdP and has received rare, successful, and appropriate ICD shocks. |
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Authors:
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Eric S Silver; Leonardo Liberman; Wendy K Chung; Henry M Spotnitz; Jonathan M Chen; Michael J Ackerman; Christopher Moir; Allan J Hordof; Robert H Pass |
Publication Detail:
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Type: Case Reports; Journal Article Date: 2009-08-11 |
Journal Detail:
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Title: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing Volume: 26 ISSN: 1572-8595 ISO Abbreviation: J Interv Card Electrophysiol Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-09-18 Completed Date: 2009-12-01 Revised Date: 2012-09-20 |
Medline Journal Info:
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Nlm Unique ID: 9708966 Medline TA: J Interv Card Electrophysiol Country: Netherlands |
Other Details:
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Languages: eng Pagination: 41-5 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, NY Presbyterian Hospital-Columbia University, New York, NY, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Combined Modality Therapy Defibrillators, Implantable* Humans Infant, Newborn Long QT Syndrome / congenital, genetics*, therapy* Male Muscle Proteins / genetics* Mutation Polymorphism, Single Nucleotide / genetics Sodium Channels / genetics* Sympathectomy* Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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R01 HD042569-09/HD/NICHD NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Muscle Proteins; 0/Sodium Channels; 0/sodium channel protein type 5 subunit alpha |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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