RESEARCH ARTICLE


QT Interval Prolongation and Atypical Proarrhythmia: Monomorphic Ventricular Tachycardia with Trimebutine



Michele Schiariti1, Angela Saladini2, Attilio Placanica1, Marta Saolini1, Paolo E. Puddu*, 3
1 Department of the Heart and Great Vessels “Attilio Reale”, University of Rome "La Sapienza”, Rome, Italy
2 Department of Cardiothoracic Surgery and Cardiology, Sant’Anna Hospital, Catanzaro, Italy
3 UOC Biotechnologies Applied to Cardiovascular Diseases, University of Rome "La Sapienza”, Rome, Italy

Article Information


Identifiers and Pagination:

Year: 2009
Volume: 3
First Page: 32
Last Page: 36
Publisher Id: TOPHARMJ-3-32
DOI: 10.2174/1874143600903010032

Article History:

Received Date: 13/5/2009
Revision Received Date: 27/5/2009
Acceptance Date: 29/5/2009
Electronic publication date: 8/7/2009
Collection year: 2009

© 2009 Schiariti et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the the Dipartimento del Cuore e Grossi Vasi “Attilio Reale”, UOC Biotecnologie Applicate alle Malattie Cardiovascolari, Università degli Studi di Roma "La Sapienza", Viale del Policlinico, 155, Rome 00161, Italy; Tel: +39.06.4455291; Fax: +39.06.4441600; E-mail: paoloemilio.puddu@uniroma1.it


Abstract

A 59-year old woman was admitted at emergency for palpitation and dizziness. Medication history showed trimebutine 450 mg daily, because of meteorism, increased to 450 mg TID a week earlier. At admittance, sustained monomorphic ventricular tachycardia was interrupted by 100 mg intravenous lidocaine and a largely prolonged QTc (523 ± 12 ms) was seen. Discontinuation of trimebutine achieved normalisation of QTc (420 ± 10 ms, p<0.001).

This is the first report in man to illustrate a probable proarrhythmic action of trimebutine. A weak inhibitory effect on both rapid and slow components of the delayed rectifier in guinea-pig ventricular myocytes calls for further investigations in human myocardial tissues. Trimebutine inhibition of Na and Ca++ channels in cardiac tissues of rabbits and guinea-pigs also call for further studies in human myocardial tissues.

Keywords: Trimebutine, proarrhythmia, prokinetic agents, QT prolongation, ventricular tachycardia, delayed rectifier K+ current.