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[Bidirectional tachycardia during therapy with lorajmine].

G A Lanza, A G Rebuzzi, P Santarelli

Cardiologia (Rome, Italy)

|October 1, 1989

Summary

Lorajmine, an antiarrhythmic drug, likely caused bidirectional tachycardia (BT) in a patient with frequent premature ventricular complexes (PVCs). This drug-induced arrhythmia was identified via Holter ECG and resolved after discontinuing lorajmine.

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Area of Science:

Cardiology
Clinical Electrophysiology
Pharmacology

Background:

A patient presented with presyncope and frequent premature ventricular complexes (PVCs).
Standard antiarrhythmic therapies including disopyramide and amiodarone were ineffective.
The patient had good myocardial function and was not on digitalis therapy.

Observation:

Holter electrocardiography (H-ECG) revealed frequent PVCs.
During lorajmine therapy (600 mg/day), numerous asymptomatic episodes of bidirectional tachycardia (BT) were observed.
Two distinct patterns of BT were identified based on PVC morphology in leads CM1 and CM5.

Findings:

Lorajmine was identified as the likely causative agent for bidirectional tachycardia.
The drug-induced BT episodes were asymptomatic.

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PVCs were effectively controlled with flecainide after lorajmine was discontinued.

Implications:

This case highlights a potential adverse effect of lorajmine, inducing bidirectional tachycardia.
Careful monitoring is essential when using antiarrhythmic drugs, particularly lorajmine.
Understanding drug-induced arrhythmias is crucial for effective patient management and treatment selection.