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BJA Advance Access published online on July 18, 2006
British Journal of Anaesthesia, doi:10.1093/bja/ael183
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Accepted June 2, 2006

Case Report

Development of torsade de pointes caused by exacerbation of QT prolongation during clipping of cerebral artery aneurysm in a patient with subarachnoid haemorrhage

I. Takenaka 1 *, K. Aoyama 1, T. Iwagaki 1, H. Ishimura 1, and T. Kadoya 1

1 Department of Anaesthesia, Nippon Steel Yawata Memorial Hospital, 1-1-1 Harunomachi, Yahatahigashi-ku, Kitakyushu 805-8508, Japan

* To whom correspondence should be addressed.
I. Takenaka, E-mail: takenaka.i{at}ns.yawata-mhp.or.jp


  Abstract

We report the case of a 79-yr-old woman with subarachnoid haemorrhage (SAH) in whom torsade de pointes (TdP) caused by worsening the QT prolongation occurred during clipping of cerebral artery aneurysm. This patient shows a potential risk of occurrence of life-threatening tachyarrhythmia, TdP by prolonging the QT interval during surgery in patients with SAH even with no additional factors that predispose to TdP. Therefore, a proper monitoring of the QT interval is necessary as a predictor of TdP. When ventricular tachyarrhythmia occurs, recognition of TdP is important because antiarrhythmic drug therapy for TdP is different from that for ventricular tachyarrhythmias that is not TdP.

Keywords: complications, prolonged QT syndrome; complications, subarachnoid haemorrhage; heart, arrhythmia, torsade de pointes.
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