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Torsades de pointes caused by Mibefradil.
S Gläser1, M Steinbach, C Opitz
1Unfallkrankenhaus Berlin, Department of Internal Medicine, Warener Strasse 7, D-12683 Berlin, Germany.
Mibefradil can cause dangerous heart rhythm problems, specifically Torsades de pointes, by prolonging the QTc interval. Discontinuing the drug resolved these life-threatening ventricular dysrhythmias.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Medicine
Background:
- Mibefradil is a calcium channel blocker.
- QTc prolongation is a risk factor for ventricular arrhythmias.
Observation:
- A 76-year-old woman experienced symptomatic Torsades de pointes.
- Significant QTc prolongation (0.53 s) was documented.
- Multiple episodes of ventricular tachyarrhythmias occurred.
Findings:
- Mibefradil use was associated with QTc prolongation.
- Discontinuation of Mibefradil led to QTc interval normalization.
- No further ventricular tachyarrhythmias were observed after drug cessation.
Implications:
- Mibefradil can induce life-threatening ventricular dysrhythmias.
- This mechanism may explain unexplained deaths linked to Mibefradil.
- Clinical vigilance for QTc prolongation is crucial when prescribing Mibefradil.
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