[Erythrocyte-induced "torsade de pointes" ventricular tachycardia].
A case of erythromycin-induced acquired long QT syndrome and "torsades de pointes" ventricular tachycardia is reported. The peculiar ventricular tachyarrhythmia was evoked by orally administered erythromycin (1.5 g/die) in the presence of diuretic (clopamide)-induced hypokalaemia. The pause-dependent "torsades de pointes" was preceded by prolonged QTU interval (560 ms), "particular bigeminy" and "short-long-short" RR interval sequence. The recurrent ventricular tachycardia causing syncopal attacks was abolished by the discontinuation of erythromycin treatment, K+/Mg(2+)-supplementation and oral mexiletine therapy. It is emphasized that the macrolide antibiotic/prokinetic erythromycin, applied in therapeutic dosages, blocks the rapidly activating delayed rectifier potassium current (IKr), and as such, prolongs ventricular repolarization and may be "torsadogenic".
Lengyel
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Szent-Györgyi Albert Orvostudományi Egyetem, Szeged.
Várkonyi
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T
Fazekas
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T
D003005:Clopamide / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004562:Electrocardiography; D004917:Erythromycin / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy; D008875:Middle Aged; D011188:Potassium / Q000627:therapeutic use; D017180:Tachycardia, Ventricular / Q000139:chemically induced*; D016171:Torsades de Pointes / Q000139:chemically induced*
D003005:Clopamide; D004917:Erythromycin; D011188:Potassium
Erythromycin által elöidézett "torsades de pointes" kamrai tachycardia.