Ventricular fibrillation in a tetraplegic patient who had a therapeutic level of a tricyclic antidepressant. Case report.

A case is presented of a young, chronic tetraplegic patient who, shortly after achieving therapeutic levels of imipramine, a tricyclic antidepressant (TCA) developed a life-threatening ventricular arrhythmia. Since tetraplegic patients frequently manifest evidence of autonomic supersensitivity, the autonomic effects of the TCA may have led to the cardiac arrhythmia. Caution should be exercised in the use of TCA's in tetraplegic patients.