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A first case report of dapsone inducing recurrent ventricular arrhythmia
Bethany Wong1, Lavanya Saiva1, John Buckley1
1Cardiology Department, Connolly Hospital, Mill Rd, Abbotstown, Dublin 15, 15 X40D, Ireland.
European Heart Journal. Case Reports
|January 9, 2020
Summary
Dapsone, an antimicrobial, may trigger life-threatening ventricular arrhythmias (VAs) in patients with pre-existing heart conditions like ischemic cardiomyopathy. Stopping the drug resolved the VAs, avoiding further intervention.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Ventricular arrhythmias (VAs) are dangerous heart rhythm disturbances linked to high morbidity and mortality.
- Factors like myocardial scar, electrolyte imbalances, and certain drugs can induce VAs by altering cardiomyocyte electrophysiology.
Observation:
- A case report details a 52-year-old man with ischemic cardiomyopathy experiencing VA storms.
- These arrhythmias were suspected to be caused by dapsone, an antimicrobial used for Pneumocystis pneumonia prophylaxis.
Findings:
- This is the first reported instance linking dapsone to the development of VAs.
- The VA storm ceased after dapsone treatment concluded, and the patient's planned sympathectomy was averted.
Implications:
- The exact mechanism of dapsone-induced VAs remains unclear, with no observed QTc prolongation in this case.
- This case highlights that in patients with underlying conditions, additional medications like dapsone can lower the threshold for potentially fatal arrhythmias.
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