Document Detail


Brugada-like ECG pattern induced by tricyclic antidepressants.
MedLine Citation:
PMID:  19996975     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
We present the case report of a 57-year-old woman with severe monointoxication with dosulepine (Prothiaden) who developed a Brugada-like electrocardiographic pattern. In tricyclic antidepressants (TCAs) poisoning the Brugada-like pattern on electrocardiogram is a characteristic albeit rare manifestation of the frequently occurring conduction abnormalities in the myocardium and its recognition is imperative as it is associated with a higher degree of morbidity and mortality. An overview of the literature is given and recommendations concerning treatment of TCA-induced arrhythmias are provided. After successful treatment, the electrocardiogram in the patient normalized. However, 4 days after intoxication, the ajmaline test was positive (pharmacological induction of a type I Brugada-like pattern), but a subsequent one, repeated after 11 days, was reportedly normal, probably because of the slow clearance of dosulepine. This raises questions about the specificity of ajmaline testing for Brugada syndrome in patients taking dosulepine and perhaps other TCAs and neuroleptic agents.
Authors:
Agna Meert; Nick Vermeersch; Rudi Beckers; Wim Hoste; Pedro Brugada; Ives Hubloue
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of emergency medicine : official journal of the European Society for Emergency Medicine     Volume:  17     ISSN:  1473-5695     ISO Abbreviation:  Eur J Emerg Med     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442482     Medline TA:  Eur J Emerg Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  325-7     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
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