title: A Case of Sudden Cardiac Death due to Pilsicainide-Induced Torsades de Pointes.
abstract: An 84-year-old male received oral pilsicainide, a pure sodium channel blocker with slow recovery kinetics, to convert his paroxysmal atrial fibrillation to a sinus rhythm; the patient developed sudden cardiac death two days later. The Holter electrocardiogram, which was worn by chance, revealed torsade de pointes with gradually prolonged QT intervals. This drug is rapidly absorbed from the gastrointestinal tract, and most of it is excreted from the kidney. Although the patient's renal function was not highly impaired and the dose of pilsicainide was low, the plasma concentration of pilsicainide may have been high, which can produce torsades de pointes in the octogenarian. Although the oral administration of class IC drugs, including pilsicainide, is effective to terminate atrial fibrillation, careful consideration must be taken before giving these drugs to octogenarians.
authors.affiliation: Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan.
authors.forename: Shimpei
authors.initials: S
authors.lastname: Nakatani
authors.affiliation: Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Taniike
authors.affiliation: Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Makino
authors.affiliation: Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Egami
authors.affiliation: Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan.
authors.forename: Ryu
authors.initials: R
authors.lastname: Shutta
authors.affiliation: Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Tanouchi
authors.affiliation: Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Nishino
keywords: Pilsicainide; Sudden cardiac death; Torsades de pointes