Massari F M, Trevano F Q, Diehl L, Romano S
Divisione di Cardiologia, Ospedale Maggiore IRCCS, Milano.
Ital Heart J Suppl. 2000 Aug;1(8):1055-8.
Cisapride is largely used in the treatment of secondary symptoms due to gastroesophageal reflux, as a prokinetic drug that increases and coordinates gastrointestinal motility and gastroesophageal sphincteric tone. Potential proarrhythmic effects of the drug have been demonstrated in several clinical studies and reported by the drug manufacturers. These effects are increased in the presence of risk factors such as renal insufficiency, electrolytic disorders, coronary artery disease and positive history for arrhythmias including atrial fibrillation and bradyarrhythmia. Therefore in such cases a careful cardiac evaluation, both clinical and electrocardiographic, is recommended. This is still not routinely performed. The following case report shows an example in which diagnosis of increased QT interval due to cisapride was missed. This caused hospitalization for malignant ventricular arrhythmias and recurrent syncope.
西沙必利作为一种促动力药物，可增强并协调胃肠蠕动及食管胃括约肌张力，主要用于治疗胃食管反流引起的继发症状。该药物潜在的促心律失常作用已在多项临床研究中得到证实，并由药品制造商报告。在存在肾功能不全、电解质紊乱、冠状动脉疾病以及有心房颤动和缓慢性心律失常等心律失常病史等危险因素的情况下，这些作用会增强。因此，在这类病例中，建议进行仔细的临床和心电图心脏评估。但目前这仍未常规开展。以下病例报告展示了一个因西沙必利导致QT间期延长而漏诊的例子。这导致患者因恶性室性心律失常和反复晕厥而住院。
