A Case Of Ventricular Tachycardia From Use Of Clomipramine At Therapeutic Dosage

Year 2015, Volume: 5 Issue: 3, 196 - 198, 28.04.2015

Mehmet Kalkan İbrahim Altun , Nuri Kose Fatih Akın Halil Beydıllı

https://doi.org/10.16899/ctd.36735

Abstract

A 57-year-old housewife was admitted to the emergency department  with a 2-hour history of palpitations and acute dyspnea. Upon  detailed examination of her medical history, it was found that she had been suffering from tachycardia attacks lasting 10-15 minutes for six months and been receiving anti-depressant therapy for ten years. Her electrocardiogram (ECG) indicated ventricular tachycardia (VT), which rapidly changed to sinus rhythm with cardioversion. Clomipramine therapy was ceased as QTc was calculated as 600 ms. At the initial 3-day follow-up, the rhythm of the patient who had three times  attacks was converted to sinus rhythm with cardioversion. Later, the  QTc value of the patient who had no VT attack  was evaluated as 420 ms in her ECG which was analyzed at the end of the first week of her hospitalization. The patient was discharged from the hospital on the fifteenth day of her hospitalization. We present a case of VT from use of clomipramine at therapeutic dosage.

Keywords

Klomipramin, long QT syndrome, ventricular tachycardia

Tedavi Dozunda Klomipramin Kullanımına Bağlı Gelişen Ventriküler Taşikardi Olgusu

Abstract

57 yaşında kadın 2 saattir devam eden çarpıntı ve nefes darlığı şikayeti ile başvurdu. Hastanın hikayesi sorgulandığında, çarpıntı ataklarının 6 aydır olduğu, 10-15 dakika sürüp geçtiği ve on yıldır antidepresan tedavi aldığı öğrenildi. Hastanın elektrokardiyogramındaki ventriküler taşikardi (VT) mevcuttu ve kardiyoversiyonla hızlı bir şekilde sinüs ritmine döndürüldü. QTc mesafesi 600 ms olarak ölçülmesi üzerine Klomipramin tedavisi kesildi. Takibinin ilk 3 gününde 3 kez oluşan ventriküler taşikardi atağı kardiyoversiyon ile sinüs ritmine döndürüldü. Hastanın yatışının ilk haftasının sonunda QTc mesafesi 420 ms olarak ölçüldü ve sonrasında hiç VF atağı olmadı. Hasta yatışının onbeşinci günü hasteneden taburcu edildi. Biz tedavi dozunda klomipramin kullanımına bağlı bir VT olgusunu sunmak istedik

Keywords

Klomipramin, long QT sendromu, ventriküler taşikardi

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