Papaverine-induced QT interval prolongation and ventricular fibrillation in a patient with a history of drug-induced QT prolongation.

Abstract

A 64-year-old woman underwent a coronary flow reserve evaluation using intracoronary-administered papaverine into the left anterior descending artery. Her baseline electrocardiogram (ECG) was normal, but toward the end of papaverine administration, the QTU intervals were excessively prolonged and torsade de pointes occurred, leading to ventricular fibrillation. Ten months previously, the patient's ECG showed mildly prolonged QTc (480 ms(1/2)), which normalized after the cessation of bepridil. This case report suggests that a history of drug-induced QT prolongation can be a risk factor for papaverine-induced fatal ventricular arrhythmia.

• Authors: Masayuki Goto, Masahito Sato, Hitoshi Kitazawa, Minoru Takahashi, Koichi Fuse, Atsushi Saito, Masaaki Okabe, Yoshifusa Aizawa
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 53 Issue 15 Pg. 1629-31 ( 2014) ISSN: 1349-7235 [Electronic] Japan
• PMID: 25088875 (Publication Type: Case Reports, Journal Article)

Chemical References

• Vasodilator Agents
• Papaverine

Topics

• Coronary Stenosis (diagnosis, drug therapy, physiopathology)
• Coronary Vessels (drug effects, physiopathology)
• Electrocardiography (drug effects)
• Female
• Fractional Flow Reserve, Myocardial (drug effects)
• Humans
• Injections, Intra-Arterial
• Middle Aged
• Papaverine (administration & dosage, adverse effects)
• Torsades de Pointes (chemically induced, physiopathology)
• Vasodilator Agents (administration & dosage, adverse effects)
• Ventricular Fibrillation (chemically induced, physiopathology)