Unusual case of severe arrhythmia developed after acute intoxication with tosylchloramide.
BACKGROUND
Drugs not commonly considered to be cardioactive agents may cause prolongation of the QT interval with resultant torsades de pointes and ventricular fibrillation. This form of drug toxicity often causes cardiac arrest or sudden death.


METHODS
After accidental ingestion of tosylchloramide a caucasian 77-year-old woman, with a family history of cardiovascular disease and hypertension, was admitted to the intensive care unit following episodes of torsades de pointes with a prolonged QT/QTc interval (640/542 ms). The patient received an implantable cardioverter-defibrillator, was discharged from the hospital with normal QT/QTc interval and did not experience additional ventricular arrhythmias during one year of follow-up.


CONCLUSIONS
This is the first report concerning an unusual case of torsades de pointes after accidental intoxication by ingestion of tosylchloramide. The pronounced impact of the oxidyzing agent tosylchloramide on the activity of some of the ion channels regulating the QT interval was identified as a probable cause of the arrhythmia.
Department of Biomedical Sciences and Public Health, University Politecnica delle Marche, Ancona, Italy.
Vincenzo
V
Lariccia
Alessandra
A
Moraca
Marco
M
Marini
Annamaria Assunta
AA
Nasti
Ilaria
I
Battistoni
Salvatore
S
Amoroso
Gian Piero
GP
Perna
D000059:Accidents; D000368:Aged; D002700:Chloramines / Q000633:toxicity*; D004202:Disinfectants / Q000633:toxicity*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced*; D016171:Torsades de Pointes / Q000139:chemically induced*; D014105:Tosyl Compounds / Q000633:toxicity*
D002700:Chloramines; D004202:Disinfectants; D014105:Tosyl Compounds; C016300:chloramine-T