Efficacy of an implantable cardioverter-defibrillator in a neonate with LQT3 associated arrhythmias.

Abstract

We present a case in which LQTS induced severe prenatal and neonatal arrhythmias. LQT3 was diagnosed (mutation R1623Q). Short-acting beta-blockers were ineffective as well as sotalol and mexiletine in preventing recurrent ventricular arrhythmias. An ICD was implanted at the age of 7 months (weight and length of the infant at implantation 6 kg and 60 cm respectively). Flecainide was prescribed in addition to the ICD implantation. After an appropriate shock the flecainide plasma levels were shown to be subtherapeutic. Readjustment of the flecainide dose resulted in adequate plasma levels. No further shocks occurred during a further 17 months follow-up period. The combination of an active can with a subcutaneous patch proved feasible, and lifesaving shocks occurred at 7 months after implantation.

• Authors: Arend D J Ten Harkel, Maarten Witsenburg, Peter L de Jong, Luc Jordaens, Marjolein Wijman, Arthur A M Wilde
• Journal: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology (Europace) Vol. 7 Issue 1 Pg. 77-84 (Jan 2005) ISSN: 1099-5129 [Print] England
• PMID: 15670972 (Publication Type: Journal Article)

Topics

• Defibrillators, Implantable
• Electric Countershock
• Electrocardiography
• Heart Defects, Congenital (therapy)
• Humans
• Infant, Newborn
• Long QT Syndrome (congenital, therapy)