Türe Mehmet, Bilici Meki, Akın Alper, Demir Fikri, Balık Hasan, Darakçı Savaş Mert
Division of Pediatric Cardiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey.
Department of Pediatrics, Dicle University Faculty of Medicine, Diyarbakır, Turkey.
Turk J Pediatr. 2019;61(4):618-621. doi: 10.24953/turkjped.2019.04.024.
Türe M, Bilici M, Akın A, Demir F, Balık H, Darakçı SM. Complete atrioventricular block associated with clozapine intoxication: case report. Turk J Pediatr 2019; 61: 618-621. Clozapine is one of the atypical anti-psychotic drugs used in the treatment of resistant schizophrenia. Although cardiac side-effects are rare, it has been reported that there may be development of myocarditis, dilated cardiomyopathy, postural orthostatic hypotension and prolonged QT duration. Complete atrioventricular (AV) block is characterized by the inability to transmit all of the atrial signal to the ventricles. Causes may be congenital, idiopathic or acquired which are associated with surgery, infection, or muscle disease. AV block is extremely serious and permanent pacemaker insertion is usually necessary for all patients. Complete AV block may develop due to clozapine intoxication through increase in vagal tonus, sinoatrial node (SN) and the inhibition of atrioventricular node signalling. The case presented here is of a 15-year old female patient who developed AV total cardiac block associated with the taking of clozapine in a suicide attempt.
图雷·M、比利奇·M、阿金·A、德米尔·F、巴利克·H、达拉奇·S·M。氯氮平中毒相关的完全性房室传导阻滞：病例报告。《土耳其儿科学杂志》2019年；61: 618 - 621。氯氮平是用于治疗难治性精神分裂症的非典型抗精神病药物之一。虽然心脏副作用罕见，但据报道可能会发生心肌炎、扩张型心肌病、体位性直立性低血压和QT间期延长。完全性房室（AV）传导阻滞的特征是无法将所有心房信号传导至心室。病因可能是先天性、特发性或后天性的，与手术、感染或肌肉疾病有关。房室传导阻滞极其严重，通常所有患者都需要植入永久性起搏器。完全性房室传导阻滞可能由于氯氮平中毒导致迷走神经张力增加、窦房结（SN）和房室结信号传导受抑制而发生。此处报告的病例是一名15岁女性患者，她在自杀企图中服用氯氮平后出现了完全性房室传导阻滞。
