Key result
Nicorandil shortens QT and abolishes Torsades de Pointes in a complete AV block case.
Why the study?
Does nicorandil abolish Torsades de Pointes in a patient with complete AV block and QT prolongation?
Case Report (n=1)
Does nicorandil abolish Torsades de Pointes in a patient with complete AV block and QT prolongation?
Nicorandil may be clinically effective against Torsades de Pointes associated with bradycardia-dependent QT prolongation.
May support nicorandil for refractory TdP in AV block; hypothesis-generating and requires prospective validation.
TdP is a serious complication of AV block. We report a case of complete AV block with QT prolongation who had bouts of TdP resistant to lidocaine and isoproterenol. Temporary pacing could not be performed, because insertion of a pacing lead triggered TdP that deteriorated into ventricular fibrillation. Nicorandil, a potassium channel opener, shortened the QT interval and abolished TdP. This may suggest that potassium channel opening drugs are clinically effective against TdP associated with bradycardia-dependent QT prolongation.
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Watanabe et al. (1999) conducted a case report in Complete atrioventricular block with QT prolongation and Torsades de Pointes (n=1). Nicorandil was evaluated on Abolition of Torsades de Pointes and shortening of QT interval. Nicorandil shortened the QT interval and abolished Torsades de Pointes in a patient with complete atrioventricular block.
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