Multiple premature beats triggered ventricular arrhythmias during pilsicainide infusion in a patient with inferior
Masaomi Chinushi1, Daisuke Izumi, Hiroshi Furushima
1School of Health Science, Niigata University School of Medicine, Niigata, Japan. masaomi@clg.niigata-u.ac.jp
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.
Related Concept Videos
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Dysrhythmias III: Characteristics of Dysrhythmias
Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Dysrhythmias IV: Characteristics of Bradyarrhythmias
Dysrhythmias II: Classification of Tachyarrhythmias
Dysrhythmias VI: Management of Dysrhythmias


