title: [Bidirectional tachycardia during therapy with lorajmine].
abstract: We report a case of bidirectional tachycardia (BT) found on Holter recording (H-ECG), likely due to antiarrhythmic therapy with lorajmine. The patient, who was not on digitalis therapy and had good myocardial function, was investigated for presyncope. H-ECG revealed frequent premature ventricular complexes (PVC). Disopyramide, lorajmine and amiodarone (in succession) were ineffective in controlling the arrhythmias. During therapy with lorajmine (600 mg/die) H-ECG showed numerous symptomless episodes of BT. Two forms of BT were found. In the first one the PVC had a right bundle branch block (BBB) pattern in lead CM1 and alternating polarity (Rs-rS) in lead CM5, whereas in the second one an alternating right and left BBB pattern in CM1 was found. PVC were subsequently controlled with flecainide. In a 4-year follow-up period the patient underwent several H-ECGs, both with and without antiarrhythmic drugs; however, BT episodes were found only during lorajmine therapy. Thus, this drug was likely responsible for the appearance of BT episodes.
authors.forename: G A
authors.initials: GA
authors.lastname: Lanza
authors.forename: A G
authors.initials: AG
authors.lastname: Rebuzzi
authors.forename: P
authors.initials: P
authors.lastname: Santarelli
authors.forename: S
authors.initials: S
authors.lastname: Tamburi
authors.forename: M
authors.initials: M
authors.lastname: Lucente
mesh_terms: D000368:Aged; D000404:Ajmaline / Q000009:adverse effects*; D015716:Electrocardiography, Ambulatory; D006801:Humans; D008297:Male; D013610:Tachycardia / Q000139:chemically induced* / Q000503:physiopathology
chemical_list: D000404:Ajmaline
vernacular_title: Tachicardia bidirezionale durante terapia con lorajmina.