Citation

Kanda H, Nakamura M, Yaguchi I, Mochizuki T, Yamamoto M, Yasuda H. Kokyu To Junkan 1997; 45(2): 197-200.

Copyright

(Copyright © 1997, Igaku Shoin)

DOI

unavailable

PMID

unavailable

Abstract

A 29-year-old man, who had been suspected to be a depressive three months before coming to our hospital, swallowed 750 mg of pilsicainide hydrochloride (Sunrythm®) with suicidal intent. His consciousness was slightly turbid and his systolic blood pressure was 60 mmHg at the time of his admission by an ambulance. Slightly high white blood cell count and abnormal values indicative of liver damage were found in laboratory examination, and incessant ventricular tachycardia was found in the electrocardiogram. Since he was diagnosed as acute intoxication due to an excess dose of pilsicainide, gastric lavage was performed with 2 L of water associated with overdrive-pacing at his right ventricle. Incessant ventricular tachycardia disappeared and returned to normal sinus rhythm in response to the gradual lowering of the pacing rates. Gastric lavage in the acute phase was assessed to be effective for prevention of further elevation of plasma pilsicamide level since the amount of pilsicainide absorbed was 49% of the amount he had taken, which was estimated from its plasma level. Prolonged PQ and QRS returned to normal in accord with decrease in the plasma pilsicainide level brought about by fluid loading. T wave was immutable, signifying that the refractory period was over. These results indicate that the toxic effect of pilsicianide shown in this patient was an in vivo reflection of its electrophysiological action.

Language: ja

Keywords

overdrive-pacing at his right ventricle; pilsicainide hydrochloride; ventricular tachycardia