Skip to main content
Postgraduate Medical Journal logoLink to Postgraduate Medical Journal
. 1979 Nov;55(649):832–835. doi: 10.1136/pgmj.55.649.832

Iatrogenic ‘torsade de pointes’ ventricular tachycardia

Nicholas G Kounis
PMCID: PMC2425796  PMID: 523378

Abstract

Three patients who developed a distinctive form of ventricular tachycardia with oscillating QRS axis, while they were receiving drugs known to prolong the repolarization time are described. In one of the patients suffering from psychiatric illness and receiving psychotropic drugs the arrhythmia was fatal. It is postulated that the tendency to this arrhythmia was augmented by repeated electric counter shocks and negative bathmotropic drugs. Functional factors may contribute to the pathogenesis of this arrhythmia which seems to constitute an entity.

Full text

PDF
832

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abildskov J. A. Adrenergic effects of the QT interval of the electrocardiogram. Am Heart J. 1976 Aug;92(2):210–216. doi: 10.1016/s0002-8703(76)80256-6. [DOI] [PubMed] [Google Scholar]
  2. Arita M., Surawicz B. Electrophysiologic effects of phenothiazines on canine cardiac fibers. J Pharmacol Exp Ther. 1973 Mar;184(3):619–630. [PubMed] [Google Scholar]
  3. Bens J. L., Duboisset M., Quiret J. C., Lesbre J. P., Bernasconi P. Syncopes par torsades de pointes induites ou favorisées par la prénylamine. Arch Mal Coeur Vaiss. 1973 Nov;66(11):1427–1434. [PubMed] [Google Scholar]
  4. Castellanos A., Jr, Salhanick L. Electrocardiographic patterns of procaine amide cardiotoxicity. Am J Med Sci. 1967 Jan;253(1):52–60. doi: 10.1097/00000441-196701000-00011. [DOI] [PubMed] [Google Scholar]
  5. Curry P., Fitchett D., Stubbs W., Krikler D. Ventricular arrhythmias and hypokalaemia. Lancet. 1976 Jul 31;2(7979):231–233. doi: 10.1016/s0140-6736(76)91029-1. [DOI] [PubMed] [Google Scholar]
  6. Evans T. R., Curry P. V., Fitchett D. H., Krikler D. M. "Torsade de pointes" initiated by electrical ventricular stimulation. J Electrocardiol. 1976;9(3):255–258. doi: 10.1016/s0022-0736(76)80053-2. [DOI] [PubMed] [Google Scholar]
  7. Fazzini P. F., Marchi F., Pucci P. Q-T lungo, sincope e prenilamina. G Ital Cardiol. 1973;3(2):233–239. [PubMed] [Google Scholar]
  8. Fazzini P., Marchi F. Ventricular tachycardia: a new iatrogenic possibility. Am Heart J. 1975 Dec;90(6):805–806. doi: 10.1016/0002-8703(75)90473-1. [DOI] [PubMed] [Google Scholar]
  9. Fowler N. O., McCall D., Chou T. C., Holmes J. C., Hanenson I. B. Electrocardiographic changes and cardiac arrhythmias in patients receiving psychotropic drugs. Am J Cardiol. 1976 Feb;37(2):223–230. doi: 10.1016/0002-9149(76)90316-7. [DOI] [PubMed] [Google Scholar]
  10. Han J., Millet D., Chizzonitti B., Moe G. K. Temporal dispersion of recovery of excitability in atrium and ventricle as a function of heart rate. Am Heart J. 1966 Apr;71(4):481–487. doi: 10.1016/0002-8703(66)90213-4. [DOI] [PubMed] [Google Scholar]
  11. Krikler D. M., Curry P. V. Torsade De Pointes, an atypical ventricular tachycardia. Br Heart J. 1976 Feb;38(2):117–120. doi: 10.1136/hrt.38.2.117. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. McCORD M. C., TAGUCHI J. T. A study of the effect of procaine amide hydrochloride in supraventricular arrhythmias. Circulation. 1951 Sep;4(3):387–393. doi: 10.1161/01.cir.4.3.387. [DOI] [PubMed] [Google Scholar]
  13. Puritz R., Henderson M. A., Baker S. N., Chamberlain D. A. Ventricular arrhythmias caused by prenylamine. Br Med J. 1977 Sep 3;2(6087):608–609. doi: 10.1136/bmj.2.6087.608. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Raynaud R., Brochier M., Néel J. L., Fauchier J. P., Raynaud P. Tachycardie ventriculaire à foyer variable et dyskaliémie. Arch Mal Coeur Vaiss. 1969 Nov;62(11):1578–1598. [PubMed] [Google Scholar]
  15. Reynolds E. W., Vander Ark C. R. Quinidine syncope and the delayed repolarization syndromes. Mod Concepts Cardiovasc Dis. 1976 Aug;45(8):117–122. [PubMed] [Google Scholar]
  16. SELZER A., WRAY H. W. QUINIDINE SYNCOPE. PAROXYSMAL VENTRICULAR FIBRILLATION OCCURRING DURING TREATMENT OF CHRONIC ATRIAL ARRHYTHMIAS. Circulation. 1964 Jul;30:17–26. doi: 10.1161/01.cir.30.1.17. [DOI] [PubMed] [Google Scholar]
  17. Slama R., Coumel P., Motte G., Gourgon R., Waynberger M., Touche S. Tachycardies ventriculaires et torsades de pointes. Frontières morphologiques entre les dysrythmies ventriculaires. Arch Mal Coeur Vaiss. 1973 Nov;66(11):1401–1411. [PubMed] [Google Scholar]
  18. Yanowitz F., Preston J. B., Abildskov J. A. Functional distribution of right and left stellate innervation to the ventricles. Production of neurogenic electrocardiographic changes by unilateral alteration of sympathetic tone. Circ Res. 1966 Apr;18(4):416–428. doi: 10.1161/01.res.18.4.416. [DOI] [PubMed] [Google Scholar]
  19. von Bernuth G., Belz G. G., Evertz W., Stauch M. QtU-abnormalities, sinus bradycardia and Adams-Stokes attacks due to ventricular tachyarrhythmia. Acta Paediatr Scand. 1973 Nov;62(6):675–679. doi: 10.1111/j.1651-2227.1973.tb17086.x. [DOI] [PubMed] [Google Scholar]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES