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A case of atypical ventricular tachycardia induced by disopyramide Akiko Yamaguchi 1 , Tetsuo Kato 1 , Etsuo Shimada 1 , Koichi Matsumoto 1 , Hiroshi Asano 1 , Yoshiji Yamane 1 , Makoto Watanabe 1 1Tokyo Kosei Nenkin Hospital pp.421-424
Published Date 1984/4/15
DOI https://doi.org/10.11477/mf.1404204434
  • Abstract
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Atypical ventricular tachycardia (AVT) develop-ed in a 82 year old man who received conventional doses of disopyramide phosphate (300mg/day) for ventricular premature beats and paroxysmal supra-ventricular tachycardia. On the twelfth day of therapy, he had an episode of syncope. At that time electrocardiogram showed ventricular tachycardia with changes in QRS axis, which represents so call-ed "atypical ventricular tachycardia" or "torsade de pointes". This arrhythmia was avated by precor-dial thump. Serum concentrations of disopyramidewere 1.59 μg/ml and 0.6μg/ml at 28 and 44 hours after the episode of AVT, and from these data disopyramide level at the time of AVT was esti-mated to be 7-8 μg/ml. This toxic level was supposed to be the cause of AVT. This elevation of plasma disopyramide level may be induced by dehydration due to gastrointestinal disorders. Monitoring of electrocardiogram and serum concentration of disopyramide should be done in all patients receiving therapy with disopyramide even in patients without risk for toxicity. Patients showing prolonged QT intervals should be followed up closely and have the drug withheld.


Copyright © 1984, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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