Atropine-induced non-sustained polymorphic ventricular tachycardia: A rare case

Aydın, Mesut; Yıldız, Abdulkadir; Polat, Nihat; Acet, Halit; İslamoğlu, Yahya

doi:10.5799/ahinjs.01.2014.03.0437

Cited by 1 publication

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References 8 publications

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“…Atropine has recently been reported to induce polymorphic ventricular tachycardia, similar to catecholamine-induced polymorphic ventricular tachycardia. As the mechanism of atropine-induced polymorphic ventricular tachycardia, the autonomic nervous system plays an important role in ischemic myocardium [1]. However, in the present case, monomorphic ventricular tachycardia was induced by atropine, probably because, given the patient's age, myocardial ischemia was unlikely.…”

Section: Discussioncontrasting

confidence: 54%

Atropine-induced monomorphic ventricular tachycardia in an adolescent: A rare case

Ohashi

Nishikawa

Yoshida

et al. 2019

Journal of Cardiology Cases

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Exercise-induced ventricular tachycardia in children is an indication for radiofrequency ablation because of the likelihood of sudden death. This therapy requires the induction of tachycardia, which is often difficult due to the patient being sedated during the procedure; isoproterenol loading and programmed stimulation, the usual methods of inducing tachycardia in such cases, are often not successful, which makes therapy difficult. Atropine, which is used for the treatment of bradyarrhythmias, may induce ventricular tachycardia by inhibiting parasympathetic nerve activity. Case reportA 13-year-old girl presented with occasional palpitations since the first grade of junior high school. Although the palpitations appeared predominantly with exercise, they sometimes occurred at rest, and lasted for up to 5 min. Since they terminated spontaneously, they were left untreated. In a school-based health screening program conducted when she was in the second grade at junior high school, tachycardia was identified by auscultation, for which she consulted a local doctor. Non-sustained ventricular tachycardia with a heart rate of 208 beats per minute that lasted for seven seconds was induced by application of a triple master exercise load. An electrocardiogram performed at that time showed ventricular tachycardia with left bundle branch block with inferior axis morphology (Fig. 1). She was therefore referred to our department for further evaluation and treatment. Echocardiography showed normal left ventricular function. Hematological investigations showed a slight increase in B-type natriuretic peptide levels to 26.8 pg/ml. We explained to the patient and parents about therapy for arrhythmia. They preferred radiofrequency ablation to medication, and furthermore, chose physical limitation until ablation. Thus, electrophysiological studies were performed with the patient sedated by propofol loading because ventricular tachycardia was easily induced by exercise load and ventricular tachycardia rate was high rate. As pacing catheter, Iuquiry catheter (Abbott Medical Global, Abbott Park, IL, USA) was used. However, ventricular tachycardia could not be induced by either programmed stimulation with atrial and right ventricular burst pacing or the same protocol on isoproterenol load of 0.01 mg/kg/min, although premature ventricular

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Section: Discussioncontrasting

confidence: 54%