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Case report
Ventricular arrhythmia and tachycardia-induced cardiomyopathy in Gitelman syndrome, hypokalaemia is not the only culpable
  1. Rashed Al Banna1,
  2. Aysha Husain2 and
  3. Bandar Al-Ghamdi3
  1. 1Medical Department, Salmaniya Medical Complex, Manama, Bahrain
  2. 2Internal Medicine cardiology unit, Salmaniya Medical Complex, Manama, Bahrain
  3. 3Heart Centre, Heart Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
  1. Correspondence to Dr Rashed Al Banna; abdullarashed{at}


Gitelman syndrome (GS) is an autosomal recessive tubulopathy recently implicated in cases with ventricular arrhythmias (VAs), the latter being considered linked to electrolytes’ imbalance. However, a direct causal relationship is considered to be an oversimplification for a complex molecular dysfunction. Recent work has suggested a degree of microvascular dysfunction in patients with GS that might be attributed as a mechanism of arrhythmia. We report a case of GS presenting with VAs complicated by cardiomyopathy. The high load of premature ventricular contractions that were attributed to the hypokalaemia has masked the presence of the left ventricular (LV) outflow tract tachycardia. Her LV systolic function recovered after successful electrophysiology ablation procedure. Atrioventricular nodal re-entry tachycardia was discovered incidentally during the study and was ablated successfully.

  • pacing and electrophysiology
  • fluid electrolyte and acid-base disturbances

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  • Contributors RAB: treating cardiologist, manuscript writing and literature review. AH: treating cardiologist, manuscript writing and literature review. BA-G: consultant cardiology electrophysiologist, involved in patient treatment and case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.