QT prolongation and possibility of ventricular arrhythmias after intracoronary papaverine.
The incidence of ventricular arrhythmias following the intracoronary injection of papaverine was assessed. A 3F coronary Doppler catheter was placed in the proximal left anterior descending artery and 6-12 mg of papaverine was injected into the left coronary artery in 42 patients. After intracoronary papaverine, the corrected QT interval on the electrocardiogram was prolonged from 0.43 +/- 0.03 to 0.49 +/- 0.07 s (p < 0.001). Occasional premature beats were observed in 2 patients (4.5%) with dilated cardiomyopathy. In 1 patient (2.3%) with 99% stenosis of the left anterior descending artery, polymorphous ventricular tachycardia with marked QT prolongation occurred. This patient also had hypokalemia (2.5 mEq/l) due to primary aldosteronism. In conclusion, careful use of intracoronary papaverine is necessary because of the risk of occasional serious ventricular arrhythmias.
Inoue
T
T
Department of Cardiology, Koshigaya Hospital, Dokkyo University School of Medicine, Saitama, Japan.
Asahi
S
S
Takayanagi
K
K
Morooka
S
S
Takabatake
Y
Y
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000187:drug effects / Q000502:physiology; D005117:Cardiac Complexes, Premature / Q000139:chemically induced / Q000503:physiopathology; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000503:physiopathology; D003326:Coronary Circulation / Q000187:drug effects*; D003327:Coronary Disease / Q000175:diagnosis* / Q000503:physiopathology; D015150:Echocardiography, Doppler / Q000187:drug effects; D004554:Electric Countershock; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006352:Heart Ventricles / Q000187:drug effects* / Q000503:physiopathology; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010208:Papaverine / Q000008:administration & dosage / Q000009:adverse effects*; D013610:Tachycardia / Q000139:chemically induced* / Q000503:physiopathology
D010208:Papaverine