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Atrial flutter and maprotiline: case report.

G Tollefson, T Lesar, C Herzog

    The Journal of Clinical Psychiatry
    |January 1, 1984
    PubMed
    Summary
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    Maprotiline, a conventional antidepressant, rarely causes atrial flutter. This cardiac event in an 80-year-old woman was likely due to noradrenergic amine reuptake blockade, causing reentrant excitation.

    Area of Science:

    • Cardiology
    • Pharmacology
    • Neuroscience

    Background:

    • Conventional antidepressants are generally considered safe regarding cardiac arrhythmias.
    • Atrial flutter is a rare but serious cardiac irregularity.

    Observation:

    • An 80-year-old female patient developed atrial flutter after 10 days of therapeutic maprotiline treatment.
    • Maprotiline is a tetracyclic antidepressant known for its noradrenergic effects.

    Findings:

    • The observed atrial flutter is an extremely rare adverse effect of conventional antidepressants.
    • The proposed mechanism involves maprotiline's blockade of noradrenergic amine reuptake.
    • This blockade may lead to reentrant excitation within the atria, triggering atrial flutter.

    Related Experiment Videos

    Implications:

    • This case highlights a rare but significant cardiac risk associated with maprotiline.
    • Understanding the mechanism can inform clinical monitoring and risk assessment for patients on maprotiline.
    • Further research into the electrophysiological effects of maprotiline is warranted.