Electrocardiogram of the month Life-threatening ventricular arrhythmia during simultaneous administration of propafenone and sotalol

Abstract

A case of a patient treated with antiarrhythmic drugs for ventricular arrhythmia occurring after viral infection of the respiratory tract is presented. In the course of preliminary cardiologic examination no organic heart disease was diagnosed. Due to numerous ventricular extrasystolic beats (16 500 per day) and short runs of non-sustained ventricular tachycardia (maximum of 4 subsequent beats) propafenone was introduced. Persistent arrhythmia was a reason for adding sotalol to that treatment in an outpatient clinic. After three weeks of such treatment the patient presented cardiac arrest in the mechanism of ventricular tachycardia and fibrillation. Successful resuscitation and drug discontinuation led to complete resolution of the life-threatening arrhythmia. No inducible complex ventricular arrhythmia was observed during electrophysiologic examination.