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The Long QT Syndrome

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Sudden Death

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 4))

Abstract

The still inadequate but increasing awareness of the existence of the idiopathic long QT syndrome (LQTS) has provided ample evidence that, as suggested by many, this disease is far from being rare. This notion, coupled with the unusual pathophysiological characteristics and with the high degree of lethality in untreated patients, explains why the LQTS has a rather unique position in the more general problem of sudden death. In fact it seems to provide a mechanistic link between neural and cardiac factors in the genesis of sudden death and represents the most provocative example of neurally mediated, noncoronary sudden cardiac death.

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References

  1. Meissner FL: Taubstummenheit and Taubstummenbildung, Leipzig and Heidelberg, 1856, p 119.

    Google Scholar 

  2. Jervell A, Lange-Nielsen F: Congenital deaf-mutism, functional heart disease, with prolongation of the QT interval and sudden death. Am Heart J 54: 59–68, 1957.

    Article  PubMed  CAS  Google Scholar 

  3. Levine SA, Woodworth CR: Congenital deaf-mutism, prolonged Q-T interval, syncopal attacks and sudden death. New Eng J Med 259: 412–417, 1958

    Article  PubMed  CAS  Google Scholar 

  4. Ward OC: New familial cardiac syndrome in children. J Irish Med Ass 54: 103–106, 1964.

    CAS  Google Scholar 

  5. Lancet, Congenital cardiac arrhythmia (annotation), 2: 26, 1964.

    Google Scholar 

  6. Romano C: Congenital cardiac arrhythmia. Lancet 1: 658–659, 1965.

    Article  PubMed  CAS  Google Scholar 

  7. Romano C, Gemme G, Pongiglione R: Aritmie cardiache rare dell’età pediatrica. Clinica Pediat 45: 658–683, 1963.

    Google Scholar 

  8. Fraser GR, Froggatt P, James TN: Congenital deafness associated with electrocardiographic abnormalities, fainting and sudden deaths. Quart J Med 33: 361–385, 1964.

    PubMed  CAS  Google Scholar 

  9. Verrier RL, Lown B: Neural influences and sudden cardiac death. Adv Cardiol 25: 155–168, 1978.

    PubMed  CAS  Google Scholar 

  10. Moss AJ, Schwartz PJ: Sudden death and the idiopathic Q-T syndrome. Am J Med 66: 6–7, 1979.

    Article  PubMed  CAS  Google Scholar 

  11. Millar K, Abildskor GA: Notched T waves in young persons with central nervous lesions. Circulation 37: 597–603, 1968.

    PubMed  CAS  Google Scholar 

  12. Schwartz PJ, Malliani A: Electrical alternation of the T wave: clinical and experimental evidence of its relationship with the sympathetic nervous system and with the long QT syndrome. Am Heart J 89: 45–50, 1975.

    Article  PubMed  CAS  Google Scholar 

  13. Froggatt P, Adgey AA: A case of cardio-auditory syndrome (long QT interval and profound deafness) diagnosed in the perinatal period and kept under surveillance for two years. Ulster Med J 47: 115–133, 1978.

    PubMed  CAS  Google Scholar 

  14. Wellens HJJ, Vermeulen A, Durrer D: Ventricular fibrillation occurring on arousal from sleep by auditory stimuli. Circulation 46: 661–665, 1972.

    PubMed  CAS  Google Scholar 

  15. Phillips J, Ichinose H: Clinical and pathological studies in the hereditary syndrome of a long QT interval, syncopal spells and sudden death. Chest 58: 236–243, 1970.

    Article  PubMed  CAS  Google Scholar 

  16. Yanowitz F, Preston JB, Abildskov JA: Functional distribution of right and left stellate innervation to the ventricles. Circ Res 18: 416–428, 1966.

    PubMed  CAS  Google Scholar 

  17. Burgess MJ, Millar K, Abildskov JA: Cancellation of electrocardiographic effects during ventricular recovery. J Electrocardiol 2: 101–108, 1969.

    Article  PubMed  CAS  Google Scholar 

  18. Kralios FA, Martin L, Burgess MJ, Millar K: Local ventricular repolarization changes due to sympathetic nerve-branch stimulation. Am J Physiol 228: 1621–1626, 1975.

    PubMed  CAS  Google Scholar 

  19. Green JR, Korovetz MJ, Shanklin DR, De Vito JJ, Taylor WJ: Sudden unexpected death in three generations. Arch Intern Med 124: 359–363, 1969.

    Article  PubMed  Google Scholar 

  20. McRae JR, Wagner GS, Rogers MC, Canent RV: Paroxysmal familial ventricular fibrillation. J Pediatr 84: 515–518, 1974.

    Article  PubMed  CAS  Google Scholar 

  21. Gavrilescu S, Luca C: Right ventricular monophasic action potentials in patients with long QT syndrome. Brit Heart J 40: 1014–1018, 1978.

    Article  PubMed  CAS  Google Scholar 

  22. Vincent GM, Abildskov JA, Burgess MJ: Q-T interval syndromes. Progr Cardiovasc Dis 16: 523–530, 1974.

    Article  CAS  Google Scholar 

  23. Schwartz PJ, Periti M, Malliani A: The long Q-T syndrome. Am Heart J 89: 378–390, 1975.

    Article  PubMed  CAS  Google Scholar 

  24. Randall WC, Rohse WG: The augmentor action of the sympathetic cardiac nerves. Circ Res 4: 470–475, 1956.

    PubMed  CAS  Google Scholar 

  25. Harris AS, Estandia A, Tillotson RF: Ventricular ectopic rhythms and ventricular fibrillation following cardiac sympathectomy and coronary occlusion. Am J Physiol 196: 505–512, 1951.

    Google Scholar 

  26. Schwartz Pi, Stone HL, Brown AM: Effects of unilateral stellate ganglion blockade on the arrhythmias associated with coronary occlusion. Am Heart J 92: 589–599, 1976.

    Article  Google Scholar 

  27. Schwartz PJ, Snebold NG, Brown AM: Effects of unilateral cardiac sympathetic denervation on the ventricular fibrillation threshold. Am J Cardiol 37: 1034–1040, 1976.

    Article  PubMed  CAS  Google Scholar 

  28. Schwartz PJ, Verrier RL, Lown B: Effect of stellectomy and vagotomy on ventricular refractoriness in dogs. Circ Res 40: 536–540, 1977.

    PubMed  CAS  Google Scholar 

  29. Schwartz PJ, Stone HL: Unilateral stellectomy and sudden death. In: Neural mechanisms in cardiac arrhythmias, Schwartz PJ, Brown AM, Mailliani A, Zanchetti A (eds), New York, Raven Press, 1978, p 107–122.

    Google Scholar 

  30. Schwartz PJ: Unilateral stellectomy and dysrhythmias. Circ Res 43: 939–940, 1978.

    PubMed  CAS  Google Scholar 

  31. McCall RB, Gebber GL, Barman SM: Spinal interneurons in the baroreceptor reflex arc. Am J Physiol 232: H657–H665, 1977.

    PubMed  CAS  Google Scholar 

  32. Schwartz PJ, Stone HL: Effects of unilateral stellectomy upon cardiac performance during exercise in dogs. Circ Res 44: 637–644, 1979.

    PubMed  CAS  Google Scholar 

  33. Austoni P, Rosati R, Gregorini L, Bianchi E, Bortolani E, Schwartz PJ: Stellectomy and exercise in man. Am J Cardiol 43: 399, (abstract) 1979.

    Google Scholar 

  34. Schwartz PJ: Experimental reproduction of the long Q-T syndrome. Am J Cardiol 41: 374, (abstract) 1978.

    Article  Google Scholar 

  35. Hageman GR, Goldberg JM, Armour JA, Randall WC: Cardiac dysrhythmias induced by autonomic nerve stimulation. Am J Cardiol 32: 823–830, 1973.

    Article  PubMed  CAS  Google Scholar 

  36. Randall WC, Thomas JX, Euler DE, Rozanski GJ: Cardiac dysrhythmias associated with autonomic nervous system imbalance in the conscious dog. In: Neural mechanisms in cardiac arrhythmias, Schwartz PJ, Brown AM, Malliani A, Zanchetti A (eds), New York, Raven Press, 1978, p 123–138.

    Google Scholar 

  37. Zipes D. Elharrar V, Watanabe AM, Gaum WE, Besch HR: Induction of ventricular fibrillation in probucoltreated dogs. Clin Res 25: 459A, 1977.

    Google Scholar 

  38. Moss Ai, MacDonald J: Unilateral cervicothoracic sympathetic ganglionectomy for the treatment of long Q-T interval syndrome. N Engl J Med 285: 903–904, 1970.

    Article  Google Scholar 

  39. Crampton RS: Preeminence of the left stellate ganglion in the long Q-T syndrome. Circulation 59: 769–778, 1979.

    PubMed  CAS  Google Scholar 

  40. Crampton RS: Another link between the left stellate ganglion and the long Q-T syndrome. Am Heart J 96: 130–132, 1978.

    Article  PubMed  CAS  Google Scholar 

  41. Coyer BH, Pryor R, Kirsch WM, Blount SJ Jr: Left stellectomy in the long QT syndrome. Chest 74: 584–586, 1978.

    Article  PubMed  CAS  Google Scholar 

  42. James TN, Froggatt P, Atkinson WJ, Lurie PR, McNamara DG, Miller WW, Schloss GT, Carroll JF, North RL: De subitaneis mortibus. XXX. Observations on the pathophysiology of the long QT syndromes with special reference to the neuropathology of the heart. Circulation 57: 1221–1231, 1978.

    PubMed  CAS  Google Scholar 

  43. Curtiss DJ, Heibel RH, Shaver JA: Autonomic maneuvers in hereditary Q-T interval prolongation (Romano-Ward syndrome). Am Heart J 95: 420–428, 1978.

    Article  PubMed  CAS  Google Scholar 

  44. Lown B: Sudden cardiac death: The major challenge confronting contemporary cardiology. Am J Cardiol 43: 313–328, 1979.

    Article  PubMed  CAS  Google Scholar 

  45. Schwartz PJ, Stone HL: Tonic influence of the sympathetic nervous system on myocardial reactive hyperemia and on coronary blood flow distribution in dogs. Circ Res 41: 51–58, 1977.

    PubMed  CAS  Google Scholar 

  46. Schwartz PJ, Stone HL: Post-denervation supersensitivity and left stellectomy. Am J Cardiol 43: 381, (abstract) 1979.

    Article  Google Scholar 

  47. Schwartz PJ: Cardiac sympathetic innervation and the sudden infant death syndrome. A possible pathogenetic link. Am J Med 60: 167–172, 1976.

    Article  PubMed  CAS  Google Scholar 

  48. Schwartz RI: The sudden infant death syndrome. In: Reviews of perinatal medicine, Scarpelli EM, Cosmi EV (eds), New York, Raven Press, vol IV, (in press).

    Google Scholar 

  49. Kralios FA, Millar K: Functional development of cardiac sympathetic nerves in newborn dogs: Evidence for asymmetrical development. Cardiovasc Res 12: 547–554, 1978.

    Article  PubMed  CAS  Google Scholar 

  50. Smith TA, Mason JM, Bell JS, Francisco JT: Sleep apnea and Q-T interval prolongation — a particularly lethal combination. Am Heart J 97: 505–508, 1979.

    Article  PubMed  CAS  Google Scholar 

  51. Schwartz PJ: Near miss sudden infant death. Lancet 11: 853, 1976.

    Article  Google Scholar 

  52. Schwartz Pi, Montemerlo M, Facchini M, Salice P, Rosti D, Poggio G, Giorgetti R. Neonatal electrocardiography and the sudden infant death syndrome. I. The QT interval through the first six months of life. (Submitted for publication.)

    Google Scholar 

  53. Slama R, Coumel Ph: Personal communication.

    Google Scholar 

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© 1980 Martinus Nijhoff Publishers bv, The Hague

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Schwartz, P.J. (1980). The Long QT Syndrome. In: Kulbertus, H.E., Wellens, H.J.J. (eds) Sudden Death. Developments in Cardiovascular Medicine, vol 4. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-8834-7_25

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  • DOI: https://doi.org/10.1007/978-94-009-8834-7_25

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-009-8836-1

  • Online ISBN: 978-94-009-8834-7

  • eBook Packages: Springer Book Archive

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