Franklin Andrew D, Llobet J Rodrigo, Sobey Christopher M, Daniels Jessica M, Kannankeril Prince J
From the Departments of Anesthesiology.
Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee.
A A Pract. 2019 Oct 1;13(7):245-249. doi: 10.1213/XAA.0000000000001036.
Ventricular tachycardia (VT) storm, defined as recurrent VT requiring electrical cardioversion ≥3 times within 24 hours, is a rare presentation of long-QT syndrome. Pharmacologic autonomic modulation and/or left cardiac sympathetic denervation are established therapies in long-QT syndrome in adults but may not be effective or practical in the emergent treatment of VT storm. We present a novel case of a child with drug-refractory VT storm and prolonged QT requiring extracorporeal membrane oxygenation (ECMO) support. Continuous stellate ganglion blockade was remarkably effective in stabilizing his rhythm and should be considered in similar pediatric cases.
室性心动过速（VT）风暴定义为在24小时内需要≥3次电复律的复发性室性心动过速，是长QT综合征的一种罕见表现。药物自主神经调节和/或左心交感神经去神经支配是成人长QT综合征的既定治疗方法，但在室性心动过速风暴的紧急治疗中可能无效或不实用。我们报告了一例新的儿童病例，该患儿患有药物难治性室性心动过速风暴且QT延长，需要体外膜肺氧合（ECMO）支持。持续星状神经节阻滞在稳定其心律方面非常有效，在类似的儿科病例中应予以考虑。
