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
- Division of Clinical Research, National Hospital Organization Yokohama
Medical Center, Totsuka-ku, Yokohama, Japan
- Department of Cardiology, National Hospital Organization Yokohama
Medical Center, Totsuka-ku, Yokohama, Japan
- 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