p.56 抽出テキスト

Circulation. 2018;138:e272–e391. DOI: 10.1161/CIR.0000000000000549 September 25, 2018 e327 CLINICAL STATEMENTS AND GUIDELINES

QT syndrome type 3 ranolazine, mexiletine, and flecainide shorten the QTc and have been used to reduce recurrent arrhythmias.S7.9.1.1-6,S7.9.1.1-7,S7.9.1.1-10 3.	 Mexiletine is an additional medication that can be used in patients with long QT syndrome and recurrent ICD shocks. Left cardiac sympathetic denervation is associated with a reduction the number of appropriate ICD shocks and VA burden.S7.9.1.1-13–S7.9.1.1-16 Reduction of the QTc to  <500 ms after left cardiac sympathetic denervation has been correlated with reduced risk of recurrent ICD shocks and frequency of symptomsS7.9.1.1-16,S7.9.1.1-52; however, SCD or SCA is reported in 3% to 10% of patients.S7.9.1.1-15,S7.9.1.1-16,S7.9.1.1-48,S7.9.1.1-50 Although arrhythmia burden is often reduced, up to 27% of high-risk patients experience at least 1 recurrence.S7.9.1.1-13,S7.9.1.1-14,S7.9.1.1-48 Patient outcomes are improved if the left cardiac sympathetic denervation is performed in centers with surgical expertise in this procedure. Use of additional medications is guided by long QT

Figure 11. Long QT syndrome type 2.

Figure 12. Long QT syndrome type 3.

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