The Open Pharmacology Journal

2009, 3 : 32-36
Published online 2009 July 8. DOI: 10.2174/1874143600903010032
Publisher ID: TOPHARMJ-3-32

QT Interval Prolongation and Atypical Proarrhythmia: Monomorphic Ventricular Tachycardia with Trimebutine

Michele Schiariti , Angela Saladini , Attilio Placanica , Marta Saolini and Paolo E. Puddu
the Dipartimento del Cuore e Grossi Vasi “Attilio Reale”, UOC Biotecnologie Applicate alle Malattie Cardiovascolari, Università degli Studi di Roma "La Sapienza", Viale del Policlinico, 155, Rome 00161, Italy;

ABSTRACT

A 59-year old woman was admitted at emergency for palpitation and dizziness. Medication history showed trimebutine 450 mg daily, because of meteorism, increased to 450 mg TID a week earlier. At admittance, sustained monomorphic ventricular tachycardia was interrupted by 100 mg intravenous lidocaine and a largely prolonged QTc (523 ± 12 ms) was seen. Discontinuation of trimebutine achieved normalisation of QTc (420 ± 10 ms, p<0.001).

This is the first report in man to illustrate a probable proarrhythmic action of trimebutine. A weak inhibitory effect on both rapid and slow components of the delayed rectifier in guinea-pig ventricular myocytes calls for further investigations in human myocardial tissues. Trimebutine inhibition of Na+ and Ca++ channels in cardiac tissues of rabbits and guinea-pigs also call for further studies in human myocardial tissues.

Keywords:

Trimebutine, proarrhythmia, prokinetic agents, QT prolongation, ventricular tachycardia, delayed rectifier K current.