Figure.1: Pre-operative ECG showing prolonged QTc with T-wave alternans.
Figure.2: Post-operative ECG showing monomorphic T-wave with loss of TWA. TWA – T wave alternans.
Case.2:
A 3 year 2-month-old boy, 2nd in birth order had uneventful antenatal and immediate post-natal period. Elder sibling had deafness with seizures and sustained sudden cardiac death before 6 months of age without being diagnosed. Mother also has prolonged QTc 560 m sec. In view of strong family history, BERA revealed severe bilateral sensorineural hearing loss with long QT syndrome. Echo revealed structurally normal heart. Child was started on high-dose propranolol, despite that he had syncopal episodes with occasional seizures. He underwent LCSD (T2-3) through left posterolateral thoracotomy. Post-operatively, reduction in QTc interval was noted with persistent TWA.