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Disopyramide-induced Torsade de Pointes

D Tzivoni, A Keren, S Stern

Archives of Internal Medicine

|June 1, 1981

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Disopyramide phosphate may cause dangerous ventricular tachycardia (torsade de pointes), especially when combined with other heart rhythm drugs. Prompt treatment with isoproterenol or pacing can effectively manage this serious arrhythmia.

Area of Science:

Cardiology
Clinical Pharmacology

Background:

Recurrent ventricular tachycardia (torsade de pointes) is a potentially fatal arrhythmia often linked to quinidine.
Disopyramide phosphate is used for atrial fibrillation, but its association with torsade de pointes requires investigation.

Observation:

Four patients developed ventricular tachycardia after standard disopyramide doses, two concurrently with amiodarone.
These events occurred within nine months of disopyramide introduction, suggesting a possible link.

Findings:

Disopyramide phosphate, particularly in combination with other QT interval-prolonging agents, may precipitate torsade de pointes.
Severe repolarization delay and bradycardia/heart block are risk factors for this arrhythmia.

Implications:

Related Experiment Videos

Clinicians should be vigilant for disopyramide-induced torsade de pointes, especially in at-risk patients.
Combination therapy with QT interval-prolonging drugs may increase the risk of this adverse event.
Isoproterenol infusion and ventricular pacing are effective management strategies.