Multiple premature beats triggered ventricular arrhythmias during pilsicainide infusion in a patient with inferior ST-segment elevation.
A 17-year-old man was referred to our hospital for treatment of common paroxysmal atrial flutter. His electrocardiogram at rest showed subtle ST-segment elevation in leads II, III, and aV(F). Intravenous pilsicainide caused further ST-segment elevation in the inferior leads, new ST-segment depression in leads V2-V6, two distinct forms of premature ventricular complexes (PVCs) triggering short runs of polymorphic ventricular tachycardia (VT). An infusion of isoproterenol suppressed these arrhythmias and normalized the ST-segment. Pilsicainide may induce PVCs and polymorphic VT in atypical Brugada syndrome.
Chinushi
Masaomi
M
School of Health Science, Niigata University School of Medicine, Niigata, Japan. masaomi@clg.niigata-u.ac.jp
Izumi
Daisuke
D
Furushima
Hiroshi
H
Watanabe
Hiroshi
H
Aizawa
Yoshifusa
Y
D000293:Adolescent; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D001282:Atrial Flutter / Q000150:complications / Q000188:drug therapy; D004562:Electrocardiography; D006801:Humans; D007262:Infusions, Intravenous; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D008297:Male; D014693:Ventricular Fibrillation / Q000139:chemically induced* / Q000175:diagnosis*; D018879:Ventricular Premature Complexes / Q000139:chemically induced* / Q000175:diagnosis*
D000889:Anti-Arrhythmia Agents; D008012:Lidocaine; C042288:pilsicainide