Key result
Long-term administration of disopyramide in a patient with sick sinus syndrome led to marked QTc prolongation and torsade de pointes, triggered by diarrhea-induced hypokalemia.
Case Report (n=1)
Long-term disopyramide therapy can lead to torsade de pointes when triggered by acute hypokalemia from events like diarrhea, highlighting the need for careful electrolyte monitoring.
Answers are grounded in this paper and cite their sources.
May prompt electrolyte vigilance with disopyramide in sick sinus syndrome; leaves open whether routine QTc monitoring prevents events.
症例は57歳女性.洞性徐拍, 洞房ブロックとともに2連発を含む心室性期外収縮 (VPC) が多発するために, disopyramideで治療中, 約7ヵ月後に自宅玄関にて隣人と会話中に突然に失神発作を生じて当科に緊急入院した.CCUにて心電図をモニター中の入院21時間後に同様の失神発作を生じ, この時の心電図にtorsade de pointes (Tdp) が記録された.QTcの経過は, disopyramide投与前は0.40秒であったが, 投与後より徐々に延長して発作の4日前には0.59秒と著明な延長を示していたが, disopyramide中止4日後には0.38秒と正常化した.本例では常用量のdisopyramideを長期内服後に初めてTdpを生じたが, 発作の前日に胃透視を行った後に下痢があり, Tdpを生じた日の血清Kが3.3mEq/lと低下していたことが特に注目される.
No takes yet. Share an insight, caveat, or question.
Yoko Okano (1989) conducted a case report in Sick sinus syndrome (n=1). Disopyramide was evaluated on Torsade de pointes. Long-term administration of disopyramide in a patient with sick sinus syndrome led to marked QTc prolongation and torsade de pointes, triggered by diarrhea-induced hypokalemia.
Synapse has enriched 10 related papers. Consider them for comparative context: