Prenylamine Induced Prolonged QT Syndrome and Ventricular Tachycardia

Abstract

INTRODUCTION:

Prenylamine a calcium antagonist is a widely used anti-angina! drug and is generally considered safe.1 Indeed very few life threatening arrhythmias have been reported with its use. 2-3 Thus the association of ventricular arrhythmias with 1)renylamine is of special interest, especially in view of the fact that it can be anticipated and thus avoided. We shall discuss the presentation and mode of treatment of two cases with prolonged QT intervals and serious symptomatic ventricular tachycardia caused by Prenylamine.

DISCUSSION:

Prenylaminc prolongs the QT interval owing to its quinidine like properties. The long rep olarisation time favours a state of asynchronous depolarization ad may lead to reentrant arrhy.t hmias.1 Ventricular tachycardia may display the features of torsade de polrtes4 in form of late diastolic ventricular premature beat, undulating QRS axis and prolonged QT interval as seen in the first case. The arrhythmia may progress to fatal ventricular fibrillation in some cases specially if its character is not recognised.  We advocate routine electrocardiographic checkup in patients on prenylamine. Particular attention must be paid to prolongation of the QT interval, which may be the harbingir of life threatening ventricular arrhythmias.