Gitelman's Syndrome With Exercise-Induced Ventricular Tachycardia

A 62-year-old female with palpitations was admitted to hospital where she recorded 12,299 monofocal ventricular premature contractions (VPCs) in 24 h and nonsustained ventricular tachycardia (VT) on exertion. She had hypokalemia with renal potassium wasting, a chloride-resistant metabolic alkalosis,...

Full description

Saved in:

Bibliographic Details
Published in:	Circulation Journal Vol. 68; no. 5; pp. 509 - 511
Main Authors:	Nakane, Eisaku, Kono, Tatsuji, Sasaki, Yosio, Tokaji, Yasunobu, Ito, Takahide, Sohmiya, Koichi, Sakai, Yasuhiko, Suwa, Michihiro, Tanaka, Takao, Nisimura, Hikaru, Kitaura, Yasusi
Format:	Journal Article
Language:	English
Published:	Japan The Japanese Circulation Society 01-05-2004
Subjects:	Catheter Ablation Electrocardiography Exercise Female Gitelman's syndrome Humans Hypokalemia - complications Magnesium Deficiency - complications Middle Aged Radionuclide Ventriculography Syndrome Tachycardia, Ventricular - diagnosis Tachycardia, Ventricular - etiology Tachycardia, Ventricular - therapy Ventricular tachycardia
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	A 62-year-old female with palpitations was admitted to hospital where she recorded 12,299 monofocal ventricular premature contractions (VPCs) in 24 h and nonsustained ventricular tachycardia (VT) on exertion. She had hypokalemia with renal potassium wasting, a chloride-resistant metabolic alkalosis, elevated plasma renin, elevated plasma aldosterone (relative to the serum K concentration), hypomagnesemia with renal magnesium wasting, decreased urine calcium excretion, and normal blood pressure. The hypokalemia and hypomagnesemia were thought to have precipitated the VT. The coronary angiogram showed normal coronary arteries; however, the left ventriculogram revealed akinesis of the posterolateral wall. Because the VT could not be induced by programmed electrical stimulation either before or during intravenous administration of isoproterenol, the VPC with the same QRS morphology as the VT became the target of radiofrequency catheter ablation (RF-CA). Intracardiac mapping showed that the earliest activation site was situated in the asynergic area of the left ventricle (LV) and radiofrequency catheter ablation directed at the LV asynergy area completely eliminated the VPCs without any complications. During the follow-up period (6 months), she was free from palpitation and VT was not clinically documented. (Circ J 2004; 68: 509 - 511)
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1346-9843 1347-4820
DOI:	10.1253/circj.68.509