Open AccessA Neonate with Long QT Syndrome, Refractory Ventricular Arrhythmias, and Lidocaine Toxicity
Author(s) -
Aruna T. Nathan,
Maryam Y. Naim,
Lisa M. Montenegro,
Victoria L. Vetter
Publication year - 2012
Publication title -
anesthesia and analgesia/anesthesia and analgesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.404
H-Index - 201
eISSN - 1526-7598
pISSN - 0003-2999
DOI - 10.1213/ane.0b013e31823ed423
Subject(s) - medicine , lidocaine , amiodarone , refractory (planetary science) , ventricular tachycardia , anesthesia , long qt syndrome , cardiology , qt interval , short qt syndrome , atrial fibrillation , physics , astrobiology
Long QT syndrome is characterized by electrocardiographic appearance of long QT intervals and propensity to polymorphic ventricular tachycardia. Aggressive anticipatory clinical management is required for a good outcome, especially in the symptomatic neonate. We present a neonate with a compound mutation with refractory ventricular tachycardia that necessitated multimodal pharmacotherapy with lidocaine, esmolol, and amiodarone along with ventricular pacing. Despite normal serum lidocaine levels, complex pharmacokinetic interactions resulted in presumed neurotoxicity due to lidocaine. This report discusses the implications and challenges of management of a neonate with compound long mutations.