Document Detail

Temporary Cardiac Pacemaker in the Treatment of Junctional Rhythm and Hypotension Due to Imipramine Intoxication.
MedLine Citation:
PMID:  21336976     Owner:  NLM     Status:  Publisher    
Tricyclic antidepressants (TCAs) account for approximately 3% of all pediatric hospitalizations due to poisoning. TCAs remain a common cause of fatal drug poisoning because of their cardiovascular toxicity as manifested by electrocardiogram (ECG) abnormalities, arrhythmias, and hypotension. We report a 15-year-old girl with junctional escape rhythm and resistant hypotension caused by severe imipramine intoxication. Initial ECG showed junctional escape rhythm (46 bpm) with no atrial activity, low QRS voltage, widening of the QRS complex (160 ms) with a right bundle branch-like pattern, R wave > 3 mm in aVR (6 mm), and prolongation of the QT interval (QTc 550 ms). Despite intravenous fluids and inotropic support, she had resistant hypotension and acute renal failure. Junctional rhythm was successfully terminated by using temporary cardiac pacemaker. Hemodialysis and hemoperfusion were also performed. She was discharged on the day 5 without any complications. During follow-up, no ECG abnormalities were noted. We reported successful use of temporary cardiac pacemaker for treatment of junctional rhythm and resistant hypotension in imipramine intoxication. The conventional methods of activated charcoal, alkalinization, and symptomatic treatment of complications are usually enough for nonlethal doses of TCA intoxication. However, in imipramine intoxication with serious arrythmias and hypotension, using temporary cardiac pacemaker, hemodialysis, and hemoperfusion can be a life-saving therapeutic approach.
Ahmet Sert; Ebru Aypar; Dursun Odabas; M Ulku Aygul
Related Documents :
11040106 - Altered expression of proteins of metabolic regulation during remodeling of the left ve...
11709416 - Myocardial distribution and regulation of grk and beta-arrestin isoforms in congestive ...
9788826 - Differential expression of tissue inhibitors of metalloproteinases in the failing human...
19829116 - Tramadol reduces myocardial infarct size and expression and activation of nuclear facto...
17646586 - A decade of short-term outcomes in post cardiac surgery ventricular assist device impla...
15334196 - Expression of inducible nitric oxide synthase is increased in patients with heart failu...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-20
Journal Detail:
Title:  Pediatric cardiology     Volume:  -     ISSN:  1432-1971     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003849     Medline TA:  Pediatr Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Pediatric Cardiology, Konya Training and Research Hospital, 42080, Konya, Turkey,
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Effect of Human Serum Albumin on the Kinetics of N-glutaryl-L-phenylalanine p-nitroanilide Hydrolysi...
Next Document:  Relationship of Brain Natriuretic Peptide Concentrations to Left Ventricular Function and Adverse Ou...