Michiels Vincent, Miljoen Hielko, Vrints Christiaan
Dept. of Cardiology, Antwerp University Hospital, Antwerp, Belgium.
Acta Cardiol. 2009 Dec;64(6):839-42. doi: 10.2143/AC.64.6.2044756.
We present a case of sotalol-induced prolongation of the QT-interval with torsades de pointes in an octogenarian who was hospitalized because of gastroenteritis causing prerenal acute renal failure. Subsequent accumulation of sotalol caused a severe prolongation of the QT-interval on the surface ECG and ultimately torsades de pointes with loss of consciousness. The patient was successfully treated with temporary cardiac pacing, intravenous magnesium sulfate and definitive withdrawal of sotalol. The electrophysiological basis of the pro-arrhythmic properties of sotalol is reviewed in brief, additional risk factors are identified and treatment is outlined.
我们报告一例八十多岁老人因肠胃炎导致肾前性急性肾衰竭住院期间，索他洛尔诱发QT间期延长并引发尖端扭转型室速的病例。随后索他洛尔的蓄积导致体表心电图QT间期严重延长，最终出现尖端扭转型室速并伴有意识丧失。患者通过临时心脏起搏、静脉注射硫酸镁以及彻底停用索他洛尔成功治愈。简要回顾了索他洛尔促心律失常特性的电生理基础，确定了其他危险因素并概述了治疗方法。
