Torsade de pointes associated with the combination of solifenacin and clenbuterol for urinary incontinence

Abstract

A 79-year-old woman undergoing medical treatment with solifenacin and clenbuterol for urinary incontinence was admitted to our hospital because of recurrent syncope. Her syncope appeared one month after the doses of clenbuterol were increased. Torsade de pointes (TdP) was evident on her Holter electrocardiogram at the time when she developed syncope. Ultimately, a cardioverter-defibrillator with dual chamber pacing capability was implanted. To our knowledge, this is the first report of TdP associated with the combination of solifenacin and clenbuterol for urinary incontinence. <Learning objective: Urinary incontinence increases with age. Muscarinic receptor antagonists are considered the mainstay of pharmacologic treatment for this condition. Some patients might be treated with a combination of a bladder selective muscarinic receptor antagonist solifenacin and a long-acting ␤2 adrenergic agonist clenbuterol. However, this combination therapy may cause torsade de pointes with syncope.>