Orthostatic induced ventricular tachycardia in a patient with Romano-Ward syndrome

A 22-year-old woman with Romano-Ward syndrome and recurrent syncope is described. On admission, orthostatic induced ventricular tachycardia could be provoked repeatedly. Therapy with propranolol, 20 mg four times daily, eliminated the arrhythmia. Holter monitoring showed no further evidence of ventricular arrhythmias. Stress test performed during follow-up under the same treatment showed an increase in heart rate from 47 to 127 per minute while the QT interval shortened from 520 to 280 msec. During follow-up of 1.5 years there have not been any further episodes of syncope.