Θεραπεία Ασυμπτωματικού Μακρού QT Συνδρόμου · 2012-03-29 ·...

Θεραπεία Ασυμπτωματικού

Μακρού QT Συνδρόμου

Κων/νος Π. Πολυμερόπουλος, FESC, FACC Δρ Ιατρικής ΑΠΘ

Επιμελητής Β`, Α` Καρδιολογική Κλινική Π.Ν.Θ.

«Γ. Παπανικολάου»

3,015 children, < 12 y.

2,772 pts, 10-20 y.

812 pts

2,759 pts

manifest or concealed LQT1 at baseline Sensitivity 90%

Specificity 92%

+ PV 74%

- PV of 97%

Θεραπευτική Προσέγγιση

Θεραπευτική Προσέγγιση

Μexiletine and LQT 3

Schwartz P. Circulation 1995

Mexiletine would shorten the QT interval in the LQT3 patients

in whom an excessive Na+ inward current appears to prolong

repolarization

Shimizu W. Circulation 1997

6 pts

This interpretation has the dramatic support of the percentage of asymptomatic patients who received an ICD based on genotype

“Even in our center (Mayo Clinic), nearly one quarter of the LQT3

patients, compared with only 6% of the LQT1 patients, were

managed with a treatment strategy that included an ICD during this

contemporary time period. However, to date, none of the LQT3

patients have experienced an appropriate ICD therapy (only

inappropriate shocks), suggesting an over-implant rate even for this

particular genotype”

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