Since the reason this blog exists at all is the sudden and unexpected death of our youngest son Daniel, presumably due to a sudden arrhythmic episode, in the absence of anything else of any significance found on his autopsy, it makes sense to being our readership updates from medical literature concerning sudden arrhythmic death syndromes or SADS. To refresh, there are a number of sudden arrhythmic death syndromes, the ones with which you are likely most familiar are Brugada Syndrome, and Long QT Syndrome, Short QT Syndrome, but there are others.
According to recent information from the SADS Foundation, the newest recommendations are that people with Brugada Syndrome, particularly with the Brugada Syndrome Type I EKG, should avoid the drug Procaine (which is an analgesic), as it has the potential to alter their EKG. Procaine is added to other drugs sometimes, especially injectable antibiotics in order to diminish pain when given as an intramuscular injection. Procaine and its related counterparts are also given during dental procedures. Certainly, we cannot completely exclude the use of these substances for those with a prior history of rhythm disturbance, but we can make our dentists and other physicians aware of a familial history of rhythm disturbances and remind them when a patient with Brugada Syndrome or arrhythmic disorder history personally, comes to the physician or dentist. It is recommended that caution and close supervision be undertaken when using these drugs on this particular patient population.
Also, it now may be possible to diagnose Long QT or the proneness to it, in fetuses of a variety of gestational ages. Children with fetal arrhythmias should be evaluated for potential Long QT syndrome by a pediatric cardiologist NO MATTER WHAT YOUR OBSTETRICIAN TELLS YOU. He or she might be an excellent obstetrician but may not be up to date on all the nuances of pediatric cardiology. More information is available on this and a variety of aspects of prenatal Long QT diagnosis, in the second article below.