{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T11:38:29Z","timestamp":1786534709160,"version":"build-2736575974"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acquired long QT syndrome (aLQTS) is a disorder of delayed myocardial repolarization induced by medications, electrolyte disturbances, and other factors, with a significantly higher risk in females than in males. Various perioperative factors can trigger aLQTS, which may lead to cardiac arrest in severe cases, yet clinical recognition remains challenging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>This article reports a 38-year-old female patient who underwent laparoscopic combined hysteroscopic tubal lavage under general anesthesia for \u201cbilateral tubal obstruction.\u201d During the procedure, the patient suddenly developed a heart rate of 40 beats per minute, followed by torsade de pointes (TdP) that rapidly progressed to cardiac arrest. The patient was successfully resuscitated after timely cardiopulmonary resuscitation, defibrillation, and pharmacological interventions. Postoperative electrocardiogram and 24-h Holter monitoring showed progressive prolongation of the QTc interval, reaching a maximum of 581\u202fms. Follow-up electrocardiogram at 1\u202fmonth post-surgery showed that the QTc interval had returned to normal (421\u202fms). Based on a review of the literature, the final diagnosis was aLQTS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>aLQTS is one of the important causes of perioperative cardiac arrest. Female sex, electrolyte disturbances, bradycardia, and QT-prolonging medications can act synergistically as triggers. Comprehensive interventions including early recognition of abnormal electrocardiographic signals, timely resuscitation, and correction of precipitating factors are key to improving prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1857566","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T04:48:41Z","timestamp":1780462121000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiac arrest due to acquired long QT syndrome during gynecologic laparoscopy: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Wenwen","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, The 960th Hospital of PLA, Jinan","place":["Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruijing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The 960th Hospital of PLA","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangwei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Jinan Municipal Hospital of Traditional Chinese Medicine","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Jinan Municipal Hospital of Traditional Chinese Medicine","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1161\/CIRCEP.111.962019","article-title":"Long-QT syndrome: from genetics to management","volume":"5","author":"Schwartz","year":"2012","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1932","DOI":"10.1016\/j.hrthm.2013.05.014","article-title":"HRS\/EHRA\/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes: document endorsed by HRS, EHRA, and APHRS in May 2013 and by ACCF, AHA, PACES, and AEPC in June 2013","volume":"10","author":"Priori","year":"2013","journal-title":"Heart Rhythm"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1016\/j.cjca.2014.03.032","article-title":"Sex differences in cardiac electrophysiology and clinical arrhythmias: epidemiology, therapeutics, and mechanisms","volume":"30","author":"Tadros","year":"2014","journal-title":"Can J Cardiol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1164028","DOI":"10.3389\/fcvm.2023.1164028","article-title":"Sex differences in long QT syndrome","volume":"10","author":"D\u00edez-Escut\u00e9","year":"2023","journal-title":"Front Cardiovasc Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/j.resuscitation.2021.02.029","article-title":"QT interval dynamics and triggers for QT prolongation immediately following cardiac arrest","volume":"162","author":"Cohen","year":"2021","journal-title":"Resuscitation"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"3997","DOI":"10.1093\/eurheartj\/ehac262","article-title":"2022 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death","volume":"43","author":"Zeppenfeld","year":"2022","journal-title":"Eur Heart J"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1056\/NEJMra032426","article-title":"Drug-induced prolongation of the QT interval","volume":"350","author":"Roden","year":"2004","journal-title":"N Engl J Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"212178","DOI":"10.1100\/2012\/212178","article-title":"Mechanisms, risk factors, and management of acquired long QT syndrome: a comprehensive review","volume":"2012","author":"Kallergis","year":"2012","journal-title":"ScientificWorldJournal"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1399","DOI":"10.1007\/s11255-021-03016-0","article-title":"Prolongation of QTc interval at the beginning and during dialysis is associated with hypervolemia and calcium and magnesium change in the first 2\u202fh","volume":"54","author":"Bozaci","year":"2022","journal-title":"Int Urol Nephrol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1136\/heart.84.3.235","article-title":"The pause that refreshes, or does it? Mechanisms in torsades de pointes","volume":"84","author":"Roden","year":"2000","journal-title":"Heart"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1016\/0735-1097(89)90082-x","article-title":"Quinidine-induced long QTU interval and torsade de pointes: role of bradycardia-dependent early afterdepolarizations","volume":"14","author":"El-Sherif","year":"1989","journal-title":"J Am Coll Cardiol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1161\/01.res.79.3.474","article-title":"The electrophysiological mechanism of ventricular arrhythmias in the long QT syndrome. Tridimensional mapping of activation and recovery patterns","volume":"79","author":"El-Sherif","year":"1996","journal-title":"Circ Res"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"682","DOI":"10.1111\/pace.12623","article-title":"Electrocardiographic and electrophysiologic effects of dexmedetomidine on children","volume":"38","author":"Ergul","year":"2015","journal-title":"Pacing Clin Electrophysiol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1016\/0002-9149(92)90154-q","article-title":"Bradycardia-induced abnormal QT prolongation in patients with complete atrioventricular block with torsades de pointes","volume":"69","author":"Kurita","year":"1992","journal-title":"Am J Cardiol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"3381","DOI":"10.1161\/01.cir.92.12.3381","article-title":"Long QT syndrome patients with mutations of the SCN5A and HERG genes have differential responses to Na+ channel blockade and to increases in heart rate. Implications for gene-specific therapy","volume":"92","author":"Schwartz","year":"1995","journal-title":"Circulation"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/j.jacep.2021.09.002","article-title":"Left cardiac sympathetic denervation for long QT syndrome: 50\u202fyears\u2019 experience provides guidance for management","volume":"8","author":"Dusi","year":"2022","journal-title":"JACC Clin Electrophysiol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1857566\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T11:09:21Z","timestamp":1786532961000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1857566\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,3]]},"references-count":16,"alternative-id":["10.3389\/fmed.2026.1857566"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1857566","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,3]]},"article-number":"1857566"}}