Torsades de pointes ventricular tachycardia induced by mosapride and flecainide in the presence of hypokalemia.
We report a 68-year-old man who developed torsades de pointes ventricular tachycardia induced by combined use of mosapride and flecainide. He had a permanent pacemaker (DDD mode) implanted because of sick sinus syndrome (bradytachy syndrome) 6 years earlier. The patient had started taking mosapride for upper abdominal discomfort 2 weeks earlier. On admission, ECG showed prolongation of the QTc interval from 0.48 to 0.56 seconds and self-terminating torsades de pointes occurred. We considered that this proarrhythmia was induced by mosapride in combination with antiarrhythmic agents.
Department of Cardiology, Jichi Medical School, Minamikawachi, Tochigi 329-0498, Japan. ruriohki@jichi.ac.jp
R
R
Ohki
M
M
Takahashi
O
O
Mizuno
H
H
Fujikawa
T
T
Mitsuhashi
T
T
Katsuki
U
U
Ikeda
K
K
Shimada
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy; D001549:Benzamides / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D005424:Flecainide / Q000009:adverse effects* / Q000627:therapeutic use; D005765:Gastrointestinal Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007008:Hypokalemia / Q000150:complications*; D008297:Male; D009025:Morpholines / Q000009:adverse effects* / Q000627:therapeutic use; D010138:Pacemaker, Artificial; D012804:Sick Sinus Syndrome / Q000628:therapy; D016171:Torsades de Pointes / Q000139:chemically induced*
D000889:Anti-Arrhythmia Agents; D001549:Benzamides; D005765:Gastrointestinal Agents; D009025:Morpholines; C062720:mosapride; D005424:Flecainide