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Related Experiment Videos

Elevated defibrillation threshold with venlafaxine therapy.

Cynthia A Carnes1, Kerry K Pickworth, Nicholas A Votolato

  • 1College of Pharmacy, Ohio State University, Columbus, Ohio 43210, USA. carnes.4@osu.edu

Pharmacotherapy
|September 2, 2004
PubMed
Summary

Antidepressant venlafaxine may increase defibrillation threshold in patients with implantable cardioverter-defibrillators (ICDs). Discontinuing venlafaxine improved ICD function in a patient with heart failure, highlighting a potential drug-device interaction.

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Area of Science:

  • Cardiology
  • Pharmacology
  • Psychiatry

Background:

  • Depression is a frequent comorbidity in patients with heart failure and implantable cardioverter-defibrillators (ICDs).
  • Managing comorbidities alongside device therapy requires careful consideration of potential drug-device interactions.

Observation:

  • A patient with nonischemic cardiomyopathy, cardiac arrest history, and depression received an ICD.
  • During initial device testing, the ICD failed to achieve internal defibrillation.

Findings:

  • Venlafaxine, an antidepressant with known cardiac sodium channel blocking properties, was identified as a potential cause for the elevated defibrillation threshold.
  • Discontinuation of venlafaxine resulted in successful internal defibrillation by the ICD.

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Implications:

  • Clinicians should consider venlafaxine's potential adverse drug-device interactions in patients with ICDs.
  • Further research is necessary to elucidate the clinical significance of venlafaxine use in the ICD population.