Kies Susan J, Pabelick Christina M, Hurley Heather A, White Roger D, Ackerman Michael J
Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Anesthesiology. 2005 Jan;102(1):204-10. doi: 10.1097/00000542-200501000-00029.
Long QT syndrome is a malfunction of cardiac ion channels resulting in impaired ventricular repolarization that can lead to a characteristic polymorphic ventricular tachycardia known as torsades de pointes. Stressors, by increasing sympathetic tone, and drugs can provoke torsade de pointes, leading to syncope, seizures, or sudden cardiac death in these patients. Beta blockade, implantation of cardioverter defibrillators, and left cardiac sympathetic denervation are used in the treatment of these patients. However, these treatment modalities do not guarantee the prevention of sudden cardiac death. Certain drugs, including anesthetic agents, are known to contribute to QT prolongation. After reviewing the literature the authors give recommendations for the anesthetic management of these patients in the perioperative period.
长QT综合征是一种心脏离子通道功能障碍，导致心室复极受损，可引发一种特征性的多形性室性心动过速，即尖端扭转型室速。应激源通过增加交感神经张力，以及药物，可诱发尖端扭转型室速，导致这些患者出现晕厥、癫痫发作或心源性猝死。β受体阻滞剂、植入心脏复律除颤器和左心交感神经去神经支配用于治疗这些患者。然而，这些治疗方式并不能保证预防心源性猝死。某些药物，包括麻醉剂，已知会导致QT间期延长。在回顾文献后，作者给出了这些患者围手术期麻醉管理的建议。
