Avoidable lethal torsade de pointes during pacemaker generator exchange caused by bepridil intoxication
Yoichi Ajiro1,2,3, Toshiharu Koike2, Takashi Saito2, Fumiaki Mori2, Kazunori Iwade2
  1. Division of Clinical Research, National Hospital Organization Yokohama Medical Center, Totsuka-ku, Yokohama, Japan
  2. Department of Cardiology, National Hospital Organization Yokohama Medical Center, Totsuka-ku, Yokohama, Japan
  3. Niijuku Co-op Clinic, Tokyo, Japan
Corresponding author: Yoichi Ajiro
Division of Clinical Research, National Hospital Organization Yokohama Medical Center; 3-60-2 Harajuku, Totsuka-ku, Yokohama, Kanagawa, 245-8575, Japan
Tel +81-45-851-2621; Fax +81-45-851-8316
E-mail:you617bacchus@gmail.com
Key Clinical Message
Regular or timely measurement of plasma bepridil concentration is important. Thus, an electrophysiologist at a pacemaker clinic should pay attention to arrhythmia management and pitfalls in hospital–clinic cooperation especially when the family physician prescribes bepridil to a pacemaker patient.
Abstract
A 92-year-old small-framed man developed torsade de pointes during pacemaker-generator exchange. His family physician prescribed bepridil 200 mg/day. High bepridil concentration of 1409 ng/mL was revealed. Electrophysiologists at pacemaker clinic should pay attention to arrhythmia management including bepridil concentration when the family physician prescribes bepridil to a pacemaker patient.
Keywords: torsade de pointes, pacemaker generator exchange, bepridil, intoxication, hospital-clinic cooperation