Report of a life-threatening arrhythmia after hospital discharge in a liver transplant recipient with previously unknown congenital long QT syndrome

The tong QT syndrome affects heart rhythm by prolonging ventricular repolar isation; it is potentially life-threatening since it can evolve into torsad es de pointes (a polymorphic ventricular tachycardia) and/or ventricular fi brillation. The case is presented of a 55-year-old liver detected by the st andard preoperative cardiological evaluation. was mild in the immediate pos t-operative period but developed Into torsades de pointes after discharge, probably as a result of therapy This case: was particularly challenging bec ause the first arrhythmic episodes were short and electocardiographically s ilent, and thus the related faints were thought to have a neurological basi s. When the true cause emerged during a monitored episode of torsades de po intes, electric defibrillation was used to restore sinus rhythm and isoprot erenol administered to increase heart I-ate and thus shorten the prolonged QT interval Long-term control was obtained by means of an implantable intra cardiac defibrillator. In orthotopic liver, transplant recipients with tong QT syndrome, particular attention should be given to post-operative therap y as some routinely used drugs can trigger life-threatening ventricular arr hythmias.