Nicorandil, a potassium channel opener, abolished torsades de pointes in a patient with complete atrioventricular block

Pacing Clin Electrophysiol. 1999 Apr;22(4 Pt 1):686-8. doi: 10.1111/j.1540-8159.1999.tb00516.x.

Abstract

TdP is a serious complication of AV block. We report a case of complete AV block with QT prolongation who had bouts of TdP resistant to lidocaine and isoproterenol. Temporary pacing could not be performed, because insertion of a pacing lead triggered TdP that deteriorated into ventricular fibrillation. Nicorandil, a potassium channel opener, shortened the QT interval and abolished TdP. This may suggest that potassium channel opening drugs are clinically effective against TdP associated with bradycardia-dependent QT prolongation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anesthetics, Local / therapeutic use
  • Anti-Arrhythmia Agents / therapeutic use*
  • Bradycardia / etiology
  • Cardiotonic Agents / therapeutic use
  • Electrocardiography / drug effects
  • Female
  • Heart Block / complications*
  • Humans
  • Isoproterenol / therapeutic use
  • Lidocaine / therapeutic use
  • Nicorandil / therapeutic use*
  • Potassium Channels / drug effects*
  • Torsades de Pointes / drug therapy*
  • Ventricular Fibrillation / etiology

Substances

  • Anesthetics, Local
  • Anti-Arrhythmia Agents
  • Cardiotonic Agents
  • Potassium Channels
  • Nicorandil
  • Lidocaine
  • Isoproterenol