Rosengarten M, Brooks R
Can J Cardiol. 1987 Jun-Aug;3(5):234-9.
A 31-year-old female had recurring palpitations and black-outs for 13 years. Hyperthyroidism was diagnosed and electrocardiogram suggested ventricular preexcitation. Despite being treated for hyperthyroidism (which rendered the patient hypothyroid) and receiving propranolol for the arrhythmia, the palpitations persisted. Electrophysiologic testing identified the patient's arrhythmia, and demonstrated that it improved with intravenous propafenone, a new type 1C antiarrhythmic medication. After two days of oral propafenone, this initially good response was followed by episodes of Torsade de pointes ventricular tachycardia with repeated cardiac arrest. Lidocaine and isoproterenol failed to control the rhythm, and the patient was stabilized by electrical cardioversions, atrial pacing and withdrawing the propafenone. Propafenone has been used to treat Torsade de pointes, but we show that it may also cause Torsade de pointes.
一名31岁女性有反复心悸和晕厥发作13年。诊断为甲状腺功能亢进，心电图提示心室预激。尽管接受了甲状腺功能亢进治疗（使患者出现甲状腺功能减退）并服用普萘洛尔治疗心律失常，但心悸仍持续存在。电生理检查确定了患者的心律失常，并显示静脉注射新型1C类抗心律失常药物普罗帕酮后心律失常有所改善。口服普罗帕酮两天后，最初的良好反应之后出现了尖端扭转型室性心动过速发作并伴有反复心脏骤停。利多卡因和异丙肾上腺素未能控制心律，通过电复律、心房起搏和停用普罗帕酮使患者病情稳定。普罗帕酮已被用于治疗尖端扭转型室性心动过速，但我们表明它也可能导致尖端扭转型室性心动过速。
