title: Acute cholestatic hepatitis and the sudden rise of the pacing threshold 5 weeks after VVI-pacemaker implantation.
abstract: The patient we describe developed a cholestatic hepatitis and an unusual threshold elevation of about 425%, coincidently, 5 weeks after pacemaker implantation. Lead dislocation, myocardial infarction or metabolic disorder could be excluded as a reason for the pacemaker complication. Neither a biliary obstruction nor an infection of the liver could be found to explain the liver injury. Most probably, both disorders were caused by propafenone (450 mg day-1), withdrawal of the drug resulted in normalization of elevated enzyme and threshold levels.
authors.affiliation: Medical Clinic, Herrsching, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Schüppel
authors.forename: M
authors.initials: M
authors.lastname: Probst
mesh_terms: D000208:Acute Disease; D000368:Aged; D002304:Cardiac Pacing, Artificial; D002779:Cholestasis / Q000150:complications / Q000503:physiopathology*; D004562:Electrocardiography; D006505:Hepatitis / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D011405:Propafenone / Q000009:adverse effects*; D013375:Substance Withdrawal Syndrome / Q000150:complications*; D013997:Time Factors
chemical_list: D011405:Propafenone