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Related Experiment Videos

Imipramine-induced heart block. A longitudinal case study.

S J Kantor, J T Bigger, A H Glassman

    JAMA
    |April 10, 1975
    PubMed
    Summary
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    Tricyclic antidepressant imipramine caused a 2:1 atrioventricular block in a patient with pre-existing right bundle-branch block. This heart block was directly related to imipramine plasma concentration, occurring in the His-Purkinje system.

    Area of Science:

    • Cardiology
    • Clinical Pharmacology

    Background:

    • Tricyclic antidepressants (TCAs) like imipramine can affect cardiac conduction.
    • Pre-existing conduction abnormalities may increase susceptibility to drug-induced cardiac events.

    Purpose of the Study:

    • To investigate the relationship between imipramine treatment and the development of atrioventricular (AV) block.
    • To determine the mechanism and location of the AV block induced by imipramine.

    Main Methods:

    • Case report of a 74-year-old male patient with a history of right bundle-branch block.
    • Serial electrocardiographic (ECG) monitoring during imipramine therapy.
    • Measurement of plasma imipramine concentrations.

    Main Results:

    Related Experiment Videos

  • Development of a 2:1 atrioventricular block during imipramine treatment.
  • Correlation between elevated plasma imipramine levels and the onset of AV block.
  • Evidence suggesting the block occurred below the AV node, within the His-Purkinje system.

    • Conclusions:

    • Imipramine can precipitate significant atrioventricular block, particularly in patients with underlying conduction defects.
    • The His-Purkinje system is a likely site for imipramine-induced conduction delay.
    • Therapeutic drug monitoring of imipramine levels is crucial in patients with cardiac conditions.