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Figure 1. A 12-year-old boy with the familial long-QT syndrome had an automatic cardioverterdefibrillator implanted after resuscitation from cardiac arrest. The device was programmed to wait 7.5 seconds before discharging in response to ventricular tachycardia or ventricular fibrillation. The boy took 120 mg of nadolol daily. Three months later, he suddenly collapsed while answering a question in school. Analysis of the cardioverterdefibrillator revealed the following sequence of events: normal sinus rhythm with a corrected QT interval of 0.66 second (top tracing) was followed by torsade de pointes (middle tracing) and ventricular fibrillation (bottom tracing), prompting discharge of the cardioverterdefibrillator . . . [Full Text of this Article] |