[Hyperkinetic ventricular arrhythmia induced by atropine administration]

We report the case of a patient with ventricular tachyarrhythmia, which occurred after atropine was given intravenously for diagnostic purposes. The arrhythmia was accompanied with precordial pain and nitroglycerin promptly reduced both events. On the ECG an elevated ST segment in leads I, aVL, V4, V5, V6 was observed for few hours after the end of the arrhythmia, followed by a pattern of myocardial ischemia. Serum enzymes were repeatedly normal. Spontaneous anginal attacks, usually accompanied with ECG signs of myocardial ischemia and 2nd degree AV block, were often observed by means of 24 hours ECG monitoring (Holter) in the following weeks, in spite of appropriate treatment. Either myocardial ischemia, induced by the increased heart rate following atropine administration, or direct electrophysiologic effects of the drug upon the ventricle muscle (possibly in association with ischemia) could have caused the ventricular arrhythmia.