A Case of Sudden Cardiac Death due to Pilsicainide-Induced Torsades de Pointes.
10.4070/kcj.2014.44.2.122
- Author:
Shimpei NAKATANI
1
;
Masayuki TANIIKE
;
Nobuhiko MAKINO
;
Yasuyuki EGAMI
;
Ryu SHUTTA
;
Jun TANOUCHI
;
Masami NISHINO
Author Information
1. Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan. mnishino@orh.go.jp
- Publication Type:Case Report
- Keywords:
Pilsicainide;
Torsades de pointes;
Sudden cardiac death
- MeSH:
Administration, Oral;
Aged, 80 and over;
Atrial Fibrillation;
Death, Sudden, Cardiac*;
Electrocardiography;
Gastrointestinal Tract;
Humans;
Kidney;
Kinetics;
Male;
Sodium Channel Blockers;
Torsades de Pointes*
- From:Korean Circulation Journal
2014;44(2):122-124
- CountryRepublic of Korea
- Language:English
-
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.
