prajmaline and Ventricular-Fibrillation

A high take-off descending ST segment associated with right bundle branch block is the typical ECG criterion of the Brugada-Brugada syndrome. It leads to ventricular fibrillation or syncopes in case of a familiar disposition.. We describe a 56-year-old man in whom oral prajmalium bitartrate therapy previously prescribed for symptomatic ventricular extrasystoles unmasked an electrographic pattern characteristic of a Brugada syndrome. After the ongoing invasive diagnostic a right ventricular dysplasia in the same case is possible. The patient was treated with an ICD pacemaker.

Topics: Anti-Arrhythmia Agents; Arrhythmogenic Right Ventricular Dysplasia; Bundle-Branch Block; Coronary Angiography; Diagnosis, Differential; Electrocardiography; Humans; Male; Middle Aged; Pacemaker, Artificial; Prajmaline; Syndrome; Treatment Outcome; Ventricular Fibrillation

Topics: Adult; Anti-Arrhythmia Agents; Cardiopulmonary Bypass; Electrocardiography; Female; Half-Life; Heart Rate; Humans; Prajmaline; Suicide, Attempted; Ventricular Fibrillation

Prajmaline is not a relatively well known and frequently used antiarrhythmic belonging to Class IA group of antiarrhythmics, which was administered to a young male with metoprolol for the treatment of parasystole. The patient took in 120 mgs prajmaline and 600 mgs metoprolol during the day of the case, which leads to cardiogenic shock, ventricular tachycardia and ventricular fibrillation. The patient's parameters were normalized after successful resuscitation, temporary pacemaker and two days long Dopamin therapy. Therapy was not regarded to be necessary for a few ventricular premature beats detected during a week observation period. The patient is without complaints now, and significant ventricular arrhythmias, or malignant ventricular ectopy hasn't been proved with ECG tests and Holter monitoring for more than three months. Due to adverse effect profile of prajmaline, even at commonly used doses it should be administered carefully and other agents should probably be considered first before beginning long term treatment with prajmaline.

Topics: Adult; Anti-Arrhythmia Agents; Dose-Response Relationship, Drug; Drug Overdose; Drug Synergism; Humans; Male; Metoprolol; Prajmaline; Shock, Cardiogenic; Ventricular Fibrillation