Multiple premature beats triggered ventricular arrhythmias during pilsicainide infusion in a patient with inferior ST-segment elevation

Pacing Clin Electrophysiol. 2006 Dec;29(12):1445-8. doi: 10.1111/j.1540-8159.2006.00562.x.

Abstract

A 17-year-old man was referred to our hospital for treatment of common paroxysmal atrial flutter. His electrocardiogram at rest showed subtle ST-segment elevation in leads II, III, and aV(F). Intravenous pilsicainide caused further ST-segment elevation in the inferior leads, new ST-segment depression in leads V2-V6, two distinct forms of premature ventricular complexes (PVCs) triggering short runs of polymorphic ventricular tachycardia (VT). An infusion of isoproterenol suppressed these arrhythmias and normalized the ST-segment. Pilsicainide may induce PVCs and polymorphic VT in atypical Brugada syndrome.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anti-Arrhythmia Agents / adverse effects*
  • Atrial Flutter / complications
  • Atrial Flutter / drug therapy
  • Electrocardiography
  • Humans
  • Infusions, Intravenous
  • Lidocaine / administration & dosage
  • Lidocaine / adverse effects
  • Lidocaine / analogs & derivatives*
  • Male
  • Ventricular Fibrillation / chemically induced*
  • Ventricular Fibrillation / diagnosis*
  • Ventricular Premature Complexes / chemically induced*
  • Ventricular Premature Complexes / diagnosis*

Substances

  • Anti-Arrhythmia Agents
  • Lidocaine
  • pilsicainide