Introduction
Bepridil is used as an anti-arrhythmic agent because of its
potassium-channel-blocking property, even though it was originally
developed as an antianginal agent because of its
calcium-channel-blocking property.1 Although it has a
potent inhibitory effect on atrial fibrillation, bepridil can cause
lethal ventricular arrhythmias such as torsade de pointes (TdP).
Therefore, atrial fibrillation management should be conducted carefully
and adequately, measuring plasma bepridil concentration regularly or
timely, when an atrial fibrillation patient is treated using
bepridil.2 However, because atrial fibrillation is a
common disease, the family physician often prescribes and manages
arrhythmia. As regards pacemaker patients, because they visit the
pacemaker clinic regularly, the responsibility of arrhythmia management
might be obscured between the family physician and the
electrophysiologist at the pacemaker clinic.
Herein, we report the case of a patient who had avoidable TdP during
pacemaker generator exchange caused by bepridil intoxication.