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Related Experiment Videos

Disopyramide-induced heart block

B I Timins, J A Gutman, J I Haft

    Chest
    |April 1, 1981
    PubMed
    Summary
    This summary is machine-generated.

    Disopyramide phosphate can cause complete heart block (CHB) in patients with pre-existing bifascicular block. Caution is advised when prescribing disopyramide to individuals with these ECG patterns.

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    Area of Science:

    • Cardiology
    • Electrophysiology
    • Pharmacology

    Background:

    • Right bundle branch block with left posterior hemiblock (LPH) is a form of bifascicular block.
    • Ventricular premature contractions can indicate underlying cardiac electrical instability.

    Observation:

    • A 57-year-old woman with pre-existing right bundle branch block and LPH developed complete heart block (CHB) after receiving disopyramide phosphate.
    • Electrocardiogram (ECG) findings suggested the block occurred within the trifascicular conduction system.
    • Upon pacemaker implantation and subsequent drug rechallenge, intermittent CHB recurred.

    Findings:

    • Disopyramide phosphate precipitated CHB in a patient with bifascicular block.
    • The trifascicular conduction system was implicated in the drug-induced block.

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  • Intermittent CHB persisted even after pacemaker implantation and drug rechallenge.

    • Implications:

    • This case highlights the potential risk of disopyramide-induced CHB in patients with bifascicular conduction abnormalities.
    • Clinicians should exercise caution when prescribing disopyramide to patients exhibiting bifascicular block patterns on ECG.
    • Careful patient selection and monitoring are crucial to prevent adverse cardiac events associated with disopyramide use.