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.