Summary. A report is presented concerning a family with heritable electrocardiographic QT-prolongation attacks of syncope and possible sudden death. In 23 family members investigated, nine living cases were found to have the anomaly. Of these nine patients at least two had had syncopes in early childhood. Hearing loss was found in three of the nine patients, but in one of them this could have been due to noise trauma and in another hearing loss was unilateral. The inheritance follows an autosomal dominant pattern. As far as we know this is the first report of this disease from The Netherlands.In 1967, Ward reported a family in which some members suffered from a new disease that he called familial cardiac arrhythmia. He described two sibs with unexplained attacks of loss of consciousness. On investigation they had distinct electrocardiographic abnormalities. There was prolongation of the QT-interval and the aspect of the ST segment was very abnormal. Abnormal electrocardiograms were recorded in 10 of 28 family members. The inheritance followed an autosomal dominant pattern.We describe here another family with the disease.
Method of InvestigationAfter ascertainment of the propositus, his parents and three brothers were also investigated. The
ResultsThe propositus, III.5, was seen at the age of 10 years in our department because of frequent syncope and because he tired easily. On admission he had a slow regular pulse and the blood pressure was normal. The heart was of normal size. The electrocardiogram showed prolongation of the QTinterval: 0-60 seconds while it should have been 0-38 seconds. The T-wave was biphasic in V1-V4 and positive in V5 and V6. Chest radiology and the phonocardiogram were normal. With audiometric testing only a slight hearing loss was recorded of ± 20 db in low frequencies until 500 Hz and a loss of ± 20 db from 1500 to 3000 Hz. The hearing loss was of the perceptive type. The values for Ca, K, Mg, SGOT, LDH, CPK, and aldolase were normal for the propositus, his parents and his three brothers. The electrocardiograms of his father (II.2) and two brothers (III.4 and III.6) were abnormal. The audiometric testing of II.2 and III.4 also demonstrated a loss of hearing. The father had a hearing loss of up to 50 db, in the high frequencies, but this could have been caused by his working in a factory.One brother (III.4) had some mild hearing loss of ± 30 db in the frequency of 4000 Hz but only in the left ear.The investigation of the five sibs of the father with their children gave the following results. In 18 family members five abnormal electrocardiograms were recorded. One sister of the father (II.3), three 158 on 1 May 2019 by guest. Protected by copyright.