Ventricular tachycardia polymorphic

Besides the class I-typical proarrhythmic risk class IA antiarrhythmics possess a marked proarrhythmic risk for the induction of torsade depointes arrhythmia (life-threatening polymorphic ventricular tachycardia observed with most action potential prolonging drugs). 

Treat polymorphic ventricular tachycardia (irregular rate and form) as ventricular fibrillation (see Table 1.9)... 

Finally, the ICH E14 guideline does not address the possible consequences of QT/ QTc shortening, which may be associated with significant arrhythmias [5,167]. Digitalis intoxication is a known example of drug-induced short QT syndrome associated with polymorphic ventricular tachycardia [ 168]. It should be acknowledged that this is an area of active research and no guidelines can be put forward at the moment. 

Paltoo, B., O Donoghue, S. and Mousavi, M.S. (2001) Levofloxacin induced polymorphic ventricular tachycardia with normal QT interval. Pace-Pacing and Clinical Electrophysiology, 24, 895-897. 

Magnesium sulfate may be effective in terminating refractory ventricular tachyarrhythmias, particularly polymorphic ventricular tachycardia. DigitaUs-induced arrhythmias are more likely in the presence of magnesium deficiency. Magnesium sulfate can be administered orally, intramuscularly, or, preferably, intravenously,... 

Unlabeled Uses Control of hemodynamicallystableventriculartachycardia, control of rapid ventricular rate due to accessory pathway conduction in preexcited atrial arrhythmias, conversion of atrial fibrillation to normal sinus rhythm, in cardiac arrest with persistent ventricular tachycardia or ventricular fibrillation, paroxysmal supraventricular tachycardia, polymorphic ventricular tachycardia or wide complex tachycardia of uncertain origin, prevention of postoperative atrial fibrillation... 

Justo D, Gal-Oz A, Paran Y, Goldin Y Zeltser D (2006). Methadone-associated Torsades de pointes (polymorphic ventricular tachycardia) in opioid-dependent patients. Addiction, 101, 1333-8... 

Papaverine Papaverine, molecular formula C20H21NO4, is an isoquinoline alkaloid isolated from poppy seeds Papaver somniferum, family Papaveraceae). This alkaloid is used mainly in the treatment of spasms and of erectile dysfunction. It is also used as a cerebral and coronary vasodilator. Papaverine may be used as a smooth muscle relaxant in microsurgery. In pharmaceutical preparations, papaverine is used in its salt form, e.g. hydrochloride, codecarboxylate, adenylate and teprosylate. The usual side-effects of papaverine treatment include polymorphic ventricular tachycardia, constipation, increased transaminase levels, hyperbihr-unemia and vertigo. 

The serum potassium concentration was 2.6 mmol/1. Catecholaminergic polymorphous ventricular tachycardia was later diagnosed. 

Gohn DC, Simmons TW. Polymorphic ventricular tachycardia (torsade de pointes) associated with the use of probucol. N Engl J Med 1992 326(21) 1435-6. 

RYR2 DISEASE CATECHOLAMINERGIC POLYMORPHIC VENTRICULAR TACHYCARDIA (CPVT)... 

Aizawa, Y., Ueda, K., Komura, S., Washizuka, T., Chinushi, M., Inagaki, N., Matsumoto, Y., Hayashi, T. and M. Takahashi, Nakano, N., Yasunami, M., Kimura, A., and Hiraoka, M. (2005). A Novel Mutation in FKBP12.6 Binding Region of the Human Cardiac Ryanodine Receptor Gene (R2401H) in a Japanese Patient with Catecholaminergic Polymorphic Ventricular Tachycardia. Int J Cardiol 99(2) 343-5. 

Hasdemir, C., Priori, S. G., Overholt, E., and Lazzara, R. (2004) Catecholaminergic Polymorphic Ventricular Tachycardia, Recurrent Syncope, and Implantable Loop Recorder. J Cardiovasc Electrophysiol 15(6) 729. 

Lahat, H., Eldar, M., Levy-Nissenbaum, E., Bahan, T., Friedman, E., Khoury, A., Lorber, A., Kastner, D. L., Goldman, B., and Pras, E. (2001). Autosomal Recessive Catecholamine- or Exercise-Induced Polymorphic Ventricular Tachycardia Clinical Features and Assignment of the Disease Gene to Chromosome lpl3-21. Circulation 103(23) 2822-7. 

Laitinen, P. J., Swan, H., and Kontula, K. (2003). Molecular Genetics of Exercise-Induced Polymorphic Ventricular Tachycardia Identification of Three Novel Cardiac Ryanodine Receptor Mutations and Two Common Calsequestrin 2 Amino-Acid Polymorphisms. Eur J Hum Genet 11(11) 888-91. 

Priori, S. G., Napolitano, C., Memmi, M., Colombi, B., Drago, F., Gasparini, M., DeSimone, L., Coltorti, F., Bloise, R., Keegan, R., Cruz Filho, F. E., Vignati, G., Benatar, A., and DeLogu, A. (2002). Clinical and Molecular Characterization of Patients with Catecholaminergic Polymorphic Ventricular Tachycardia. Circulation 106(1) 69-74. 

Sumitomo, N., Harada, K., Nagashima, M., Yasuda, T., Nakamura, Y., Aragaki, Y., Saito, A., Kurosaki, K., Jouo, K., Koujiro, M., Konishi, S., Matsuoka, S., Oono, T., Hayakawa, S., Miura, M., Ushinohama, H., Shibata, T., and Niimura, I. (2003). Catecholaminergic Polymorphic Ventricular Tachycardia Electrocardiographic Characteristics and Optimal Therapeutic Strategies to Prevent Sudden Death. Heart 89(1) 66-70. 

Leenhardt, A., Lucet, V., Denjoy, I., etal., 1995, Catecholaminergic polymorphic ventricular tachycardia in children. A 7-year follow-up of 21 patients. Circulation, 91(5), pp 1512-9. 

Lehnart, S.E., Wehrens, X.H., Laitinen, P.J., et al., 2004, Sudden death in familial polymorphic ventricular tachycardia associated with calcium release channel (ryanodine receptor) leak. Circulation, 109(25), pp 3208-14. 

Electrocardiogram from a patient with the long QT syndrome during two episodes of torsade de pointes. The polymorphic ventricular tachycardia is seen at the start of this tracing and spontaneously halts at the middle of the panel. A single normal sinus beat (NSB) with an extremely prolonged QT interval follows, succeeded immediately by another episode of ventricular tachycardia of the torsade type. The usual symptoms would be dizziness or transient loss of consciousness. 

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