Review
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Cardiol. Apr 26, 2013; 5(4): 87-93
Published online Apr 26, 2013. doi: 10.4330/wjc.v5.i4.87
Drugs to be avoided in patients with long QT syndrome: Focus on the anaesthesiological management
Giovanni Fazio, Federica Vernuccio, Giuseppe Grutta, Giuseppe Lo Re
Giovanni Fazio, Federica Vernuccio, Giuseppe Grutta, Poliambulatorio medico Riabiliter S.N.C., Via Oreto, 90124 Palermo, Italy
Giuseppe Lo Re, University of Palermo, 90124 Palermo, Italy
Author contributions: Fazio G, Vernuccio F, Grutta G and Lo Re Gcontributed equally to this paper; Fazio G substantially contributed to the design of the article, its drafting and critical revision and approved the version to be published; Vernuccio F subastantially contributed to the collection of the references, to the drafting of the article and finally approved the version to be published; Grutta G substantially contributed to the conception of the article, its drafting and approved the version to be published; Lo Re G substantially contributed to the revision of the article and approved the final version of the article.
Correspondence to: Giovanni Fazio, MD, PhD, Poliambulatorio medico Riabiliter S.N.C.,Via Oreto, 340, 90124 Palermo, Italy. giovanniii@inwind.it
Telephone: +39-333-4439962 Fax: +39-333-4439962
Received: January 8, 2013
Revised: March 21, 2013
Accepted: March 28, 2013
Published online: April 26, 2013
Processing time: 109 Days and 13.5 Hours
Abstract

Long QT syndrome incidence is increasing in general population. A careful pre-, peri- and post-operative management is needed for patients with this syndrome because of the risk of Torsades de Pointes and malignant arrhythmias. The available data regarding prevention of lethal Torsades de Pointes during anesthesia in patients with long QT syndrome is scant and conflicting: only case reports and small case series with different outcomes have been published. Actually, there are no definitive guidelines on pre-, peri- and post-operative anesthetic management of congenital long QT syndrome. Our review focuses on anesthetic recommendations for patients diagnosed with congenital long QT syndrome furnishing some key points for preoperative optimization, intraoperative anesthetic agents and postoperative care plan, which could be the best for patients with c-long QT syndrome who undergo surgery.

Keywords: Long QT Syndrome; Torsades de pointes; Anesthesia; QT-prolongation; Anesthetic drugs

Core tip: Long QT syndrome is a cardiac conduction disorder characterized by prolongation and increased dispersion of ventricular repolarization, manifested by lengthening of the QT interval on the surface electrocardiography. This review furnishes important key points for preoperative optimization, intraoperative anesthetic agents and postoperative care in order to fill the lack of definitive guidelines on anesthetic management of c-long QT syndrome.