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Related Experiment Videos

Moricizine induced increase in pacing threshold.

John P Girod1, Nassir Marrouche, Michael S Chen

  • 1Department of Cardiovascular Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave., Desk F-15, Cleveland, OH 44195, USA.

Pacing and Clinical Electrophysiology : PACE
|April 11, 2003
PubMed
Summary

Moricizine effectively controlled ventricular tachycardia in a patient refractory to amiodarone. However, higher doses caused symptomatic bradycardia and pacing issues, highlighting the need for careful titration of this antiarrhythmic drug.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Pharmacology

Background:

  • A 72-year-old female presented with refractory incessant ventricular tachycardia (VT) and frequent automatic implantable cardioverter-defibrillator (AICD) discharges.
  • Standard antiarrhythmic therapies, including amiodarone, were ineffective in managing the patient's VT.
  • Myocardial ischemia and infarction were excluded as potential causes.

Observation:

  • Moricizine was initiated at 200 mg three times daily and successfully suppressed the ventricular tachycardia.
  • Upon upward dose titration of moricizine, the patient developed symptomatic bradycardia.
  • Electrocardiogram (ECG) revealed a 2:1 block in the paced rhythm and an elevated ventricular pacing threshold.

Findings:

  • Moricizine demonstrated efficacy in controlling refractory VT.

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  • Increased moricizine dosage led to significant bradycardia and conduction abnormalities.
  • Ventricular pacing parameters were adversely affected by higher moricizine doses.

    • Implications:

    • Moricizine can be an effective option for managing refractory VT.
    • Careful dose titration of moricizine is crucial to avoid adverse effects like bradycardia and pacing complications.
    • Monitoring of cardiac rhythm and pacing thresholds is essential during moricizine therapy, especially with dose adjustments.