The Korean Journal of Emergency Medical Services (한국응급구조학회지)

The Korea Society of Emergency Medical Services (한국응급구조학회)
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Case report : Administration of amiodarone for polymorphic ventricular tachycardia due to long QT syndrome during out-of-hospital advanced cardiac life support

병원 밖 전문 심장소생술에서 긴QT증후군에 의한 Polymorphic Ventricular Tachycardia에 아미오다론이 투여된 1예

  • Kang, Min Seong (Department of Preventive Medicine, College of Medicine, Hanyang University) ;
  • Kim, Ji-Won (Department of Emergency Medicine, College of medicine, Dankook University)
  • 강민성 (한양대학교 의과대학 예방의학교실) ;
  • 김지원 (단국대학교 의과대학 응급의학교실)
  • Received : 2020.07.27
  • Accepted : 2020.12.18
  • Published : 2020.12.31
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Abstract

Torsades de pointes refers to polymorphic ventricular tachycardia (PMVT), which is caused by the suppression of potassium channels owing to genetic and electrolytic abnormalities, resulting in the extension of the QT interval. Symptoms range from spontaneous circulation recovery to fainting and sudden death. Defibrillation, magnesium correction, and the use of lidocaine as an antiarrhythmic agent are recommended as treatments for persistent torsades de pointes. Currently, only amiodarone is available in the ambulance; however, torsades de pointes does not respond efficiently to amiodarone because it suppresses potassium channels and increases the refractory period of the myocardium. Lidocaine, in contrast, reduces the relative refractory period of the myocardium caused by suppressing sodium channels; thus, it inhibits the occurrence of and treats arrhythmia. In cases where PMVT did not respond to defibrillation, the administration of lidocaine showed no difference in survival and discharge rates compared to amiodarone. Thus, ambulances must be equipped with provisions to administer lidocaine.

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