title: Nicorandil, a potassium channel opener, abolished torsades de pointes in a patient with complete atrioventricular block.
abstract: TdP is a serious complication of AV block. We report a case of complete AV block with QT prolongation who had bouts of TdP resistant to lidocaine and isoproterenol. Temporary pacing could not be performed, because insertion of a pacing lead triggered TdP that deteriorated into ventricular fibrillation. Nicorandil, a potassium channel opener, shortened the QT interval and abolished TdP. This may suggest that potassium channel opening drugs are clinically effective against TdP associated with bradycardia-dependent QT prolongation.
authors.affiliation: Third Department of Internal Medicine, Saitama Medical Center, Saitama Medical School, Kawagoe, Japan.
authors.forename: O
authors.initials: O
authors.lastname: Watanabe
authors.forename: T
authors.initials: T
authors.lastname: Okumura
authors.forename: H
authors.initials: H
authors.lastname: Takeda
authors.forename: W
authors.initials: W
authors.lastname: Nakamura
authors.forename: K
authors.initials: K
authors.lastname: Segawa
authors.forename: H
authors.initials: H
authors.lastname: Ito
authors.forename: N
authors.initials: N
authors.lastname: Yoshimoto
mesh_terms: D000368:Aged; D000779:Anesthetics, Local / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001919:Bradycardia / Q000209:etiology; D002316:Cardiotonic Agents / Q000627:therapeutic use; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006327:Heart Block / Q000150:complications*; D006801:Humans; D007545:Isoproterenol / Q000627:therapeutic use; D008012:Lidocaine / Q000627:therapeutic use; D020108:Nicorandil / Q000627:therapeutic use*; D015221:Potassium Channels / Q000187:drug effects*; D016171:Torsades de Pointes / Q000188:drug therapy*; D014693:Ventricular Fibrillation / Q000209:etiology
chemical_list: D000779:Anesthetics, Local; D000889:Anti-Arrhythmia Agents; D002316:Cardiotonic Agents; D015221:Potassium Channels; D020108:Nicorandil; D008012:Lidocaine; D007545:Isoproterenol