Kawabata Mihoko, Hirao Kenzo, Takeshi Sasaki, Sakurai Kaoru, Inagaki Hiroshi, Hachiya Hitoshi, Isobe Mitsuaki
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
J Electrocardiol. 2008 Mar-Apr;41(2):117-22. doi: 10.1016/j.jelectrocard.2007.09.009.
We report 2 patients in whom transient marked QT prolongation occurred after successful emergent percutaneous coronary intervention (PCI) for acute coronary syndrome. One patient developed torsades de pointes. In both cases, the QT interval became markedly prolonged within 24 hours after PCI, and this prolongation persisted for 4 days. The T waves had a giant and bizarre negative shape with a prolonged T-wave peak to T-wave end interval. No new-onset ischemia or congenital long QT syndrome was related to the episodes. The patients had not taken any drugs that could have prolonged the QT interval, and their serum potassium levels were within normal limits. Torsades de pointes following successful PCI for acute coronary syndrome is uncommon, but acquired long QT syndrome should be considered and treated in patients in whom giant and bizarre negative T waves and QT prolongation develop after PCI.
我们报告了2例急性冠状动脉综合征患者，在成功进行急诊经皮冠状动脉介入治疗（PCI）后出现短暂性显著QT间期延长。其中1例患者发生了尖端扭转型室速。在这两例病例中，QT间期在PCI后24小时内显著延长，并持续了4天。T波呈巨大且怪异的负向形态，T波峰至T波终末间期延长。发作与新发缺血或先天性长QT综合征无关。患者未服用任何可能延长QT间期的药物，其血清钾水平在正常范围内。急性冠状动脉综合征成功PCI后发生尖端扭转型室速并不常见，但对于PCI后出现巨大怪异负向T波和QT间期延长的患者，应考虑并治疗获得性长QT综合征。
