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A Case of a Patient who Had a Recurrence of Polymorphic Ventricular Tachycardia after Continuous Treatment with Disopyramide for 8 Years Michitaka Nagashima 1 , Tatsuro Uchida 1 , Mika Tanaka 1 , Kenji Enta 1 , Fumiaki Mori 1 , Kimiharu Imamura 1 , Yasuki Hen 1 , Shunsuke Tanino 1 , Shinya Kasahara 1 , Koshichiro Hirosawa 1 1Department of Cardiology, Sendai Cardiovascular Disease Center Keyword: 多形性心室頻拍 , disopyramide , 右脚ブロックとST上昇 , polymorphic ventricular tachycardia , right bundle branch block pattern and ST segment elevation pp.1031-1035
Published Date 1998/10/15
DOI https://doi.org/10.11477/mf.1404901782
  • Abstract
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We describe a patient of polymorphic ventricular tachycardia, who had a recurrence of the complaint after continuous treatment with disopyramide for 8 years. A 53-year-old male was admitted to our hospital because of syncopal attacks in 1989. His electrocardio-gram showed polymorphic ventricular tachycardia at repetitive syncope without QT interval prolongation. Disopyramide. 300 mg/day, was effective to prevent the attack, although right bundle branch block pattern and ST segment elevation in precordial leads became appar-ent. The patient was well until June in 1997, when he was readmitted to our hospital because syncope had recurred. Two days before the second admission, the dose of disopyramide was increased to 450mg/day because follow-up Holter electrocardiogram had shown triplets of premature ventricular contraction. Because of the efficacy of disopyramide for 8 years, intravenous administration of disopyramide was started but the frequency of polymorphic ventricular tachycardia and syncope worsened, while ST segment elevation became more prominent and QT interval prolonged. Right ventricular pacing suppressed ventricular tachycardia, but lidocaine and magnesium sulfate did not. Right bundle branch block pattern, ST segment elevation and QT interval normalized without recurrence of syncope soon after disopyramide was discontinued. Even though the effect of disopyramide such as right bundle branch block pattern and ST segment elevation was evident throughout 8 years, syncopal attack had been suppres-sed. Thus the dose-dependent effect of disopyramide seemed to relate with this characteristic QRS-ST com-plex and the suppression and exacerbation of polymor-phic ventricular tachycardia in this patient.


Copyright © 1998, 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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