A severely obese patient surviving cardiopulmonary arrest and exhibiting an interesting relationship between excessive weight loss and electrocardiographic QT interval prolongation

Abstract

We report a patient with severe obesity who suffered cardiopulmonary arrest (CPA) after drastic weight loss but successfully survived with cardiopulmonary resuscitation and critical care in the ICU. We describe the patient's care and discuss the relationship between drastic weight loss and secondary prolongation of corrected QT interval (long QT syndrome) with development of torsades de pointes (Tdp). The corrected QT interval (QTc) observed upon the first visit of the patient to the outpatient unit was 0.475 sec, with a body mass index (BMI) of 67.5. QTc was prolonged to 0.507 sec after drastic weight reduction to achieve a BMI of 60.8. That was further prolonged to 0.608 sec upon ICU admission following resuscitation. Postresuscitation treatment in the ICU was successful, and she was discharged from the ICU on the 7th day. Strict medical weight control after discharge from the ICU successfully shortened QTc within the normal range. The relationship between BMI and QTc observed in the present case suggests that severe obesity and excessive weight loss caused prolongation of QTc and CPA. These findings contribute to elucidation of the pathology of sudden death in the severe obese population.