Sildenafil abolished late premature ventricular complexes and substantially reduced early ones, delaying their onset by 21 ms from the preceding T wave apex in a patient with systemic sclerosis.
Case Report (n=1)
Does sildenafil suppress premature ventricular complexes in a human patient?
This case report provides the first clinical evidence suggesting that sildenafil may have anti-arrhythmic properties in humans by suppressing premature ventricular complexes.
The phosphodiesterase-5 inhibitor sildenafil suppresses ventricular arrhythmias in a sheep model of drug-induced long QT. In that study, ventricular arrhythmias were abolished by reducing premature ventricular complexes (PVCs) and delaying PVC onset, thus preventing 'R-on-T' ventricular tachycardia. Evidence for effects in humans with arrhythmias is lacking. In this case study, a 50-year-old female with a history of PVCs and systemic sclerosis was started on sildenafil for Raynaud's phenomenon in line with current treatment recommendations. During initiation, the patient wore a 7-day cardiac monitor. Two subtypes of PVCs were observed: one distinct morphology arising 400 ms from the preceding sinus beat ('late'). Sildenafil abolished late PVCs and substantially reduced the frequency of early PVCs. Of those early PVCs remaining during sildenafil treatment, PVCs arose later in the cardiac cycle, 21 ms further from the preceding T wave apex. During washout, PVCs returned in frequency and timing towards baseline values. We report the first case suggesting an anti-arrhythmic property of sildenafil in a human.
Hutchings et al. (Wed,) conducted a case report in Premature ventricular complexes and systemic sclerosis (n=1). Sildenafil vs. Baseline/Washout was evaluated on Frequency and timing of premature ventricular complexes. Sildenafil abolished late premature ventricular complexes and substantially reduced early ones, delaying their onset by 21 ms from the preceding T wave apex in a patient with systemic sclerosis.