Pheochromocytoma associated ventricular tachycardia blocked with atenolol

Abstract

Ventricular tachycardia in patients with phenochromocytoma is rare. We report a patient with a norepinephrine-secreting extra-adrenal pheochromocytoma who had exercise induced ventricular tachycardia. Prior to diagnosis, the patient was treated with a selective beta 1 blocker, atenolol, which resulted in suppression of the dysrhythmia and amelioration of the hypertension. This is the first reported case of selective beta blockade suppressing ventricular tachycardia in a patient with a pheochromocytoma. Electrocardiographic abnormalities described in patients with pheochromocytoma are reviewed.

ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

“…The incidence is likely to be low and possibly exacerbated by reversible catecholamine-induced HCM/DCM (533). Not only will conventional antagonism of catecholamine excess with alpha receptor blockers followed by beta blockade help control hypertension and reverse or prevent any further structural deterioration (534), but there is anecdotal evidence that it prevents recurrence of ventricular arrhythmia (535). Early definite surgical treatment of the pheochromocytoma should be a priority, especially in cases with documented life-threatening arrhythmias.…”

Emergencies Caused by Pheochromocytoma, Neuroblastoma, or Ganglioneuroma

“…Although sinus tachycardia occurs most frequently, pheochromocytomas have been associated with a wide variety of arrhythmias, including supraventricular [34], nodal [35], broad complex [36], ventricular tachycardia [37][38][39], torsade de pointes [40], and Wolff-Parkinson-White syndrome [41]. Furthermore, atrial fibrillation [42] and ventricular fibrillation [5,43,44] have been reported.…”

Biochemical diagnosis, localization and management of pheochromocytoma: focus on multiple endocrine neoplasia type 2 in relation to other hereditary syndromes and sporadic forms of the tumour

“…In case of atrial fibrillation or flutter, the cardioselective β 1‐blocker esmolol can be given intravenously, provided adequate α ‐blockade has been ensured [52]. Lidocaine or atenolol have been used with success for ventricular arrhythmias [52, 53].…”