Papaverine-Induced Polymorphic Ventricular Tachycardia in Relation to QTU and Giant T-U Waves in Four Cases
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概要
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Objective Papaverine is used for the evaluation of functional status of the coronary arteries but it may provoke severe ventricular tachyarrhythmias (VTAs). This study compared the clinical and ECG characteristic of patients with papaverine-induced VTAs. Materials and Methods The study involved 25 patients who underwent a fractional flow reserve (FFR) study. FFR was determined as the ratio of blood pressure at the distal and the proximal site of stenosis after intracoronary papaverine administration at 12 mg into the left and 8 mg into the right coronary artery. The QT and QTU intervals were measured manually in the limb leads and in the precordial leads, respectively and corrected by the R-R interval to obtain QTc and QTUc. The clinical and ECG data were compared between the patient groups with and without VTAs. Results After papaverine administration into the left (20), right (3) or both coronary arteries (2), the RR interval shortened, but non-significantly however, the QT interval (and QTc) and the QTU interval (and QTUc) were significantly prolonged. VTAs developed in four women: torsade de pointes in 3 followed by ventricular fibrillation and ventricular premature beats in 1 patient. After papaverine administration, QTU and QTUc were more prolonged in women than men and in patients with VTAs compared to those without. Just prior to VTAs, giant T-U waves were observed. Conclusion Intracoronary papaverine was used to determine FFR which may induce VTAs. VTAs developed only in women and they were closely related to prolongation of the QTU intervals with prominent T-U waves.
著者
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Fuse Koichi
Cardiovascular Center Tachikawa General Hospital
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Okabe Masaaki
Cardiovascular Center Tachikawa General Hospital
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Kitazawa Hitoshi
Cardiovascular Center Tachikawa General Hospital
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Tanaka Nobuhiro
Department Of Cardiology Tokyo Medical University
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Yamashina Akira
Department Of Cardiology Tokyo Medical University
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Takahashi Minoru
Cardiovascular Center Tachikawa General Hospital
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Aizawa Yoshifusa
Department Of Cardiology Keio University School Of Medicine
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NAKAYAMA Masafumi
Cardiovascular Division, Showa University Fujigaoka Hospital
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Sato Masahito
Cardiology, Tachikawa General Hospital
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Saito Atsushi
Cardiovascular Center, Tachikawa General Hospital, Japan
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Saito Atsushi
Cardiovascular Center, Tachikawa General Hospital
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Okabe Masaaki
Cardiovascular Center, Tachikawa General Hospital, Japan
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Hoshino Kou
Department of Cardiology, Tokyo Medical University, Japan
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Fuse Koichi
Cardiovascular Center, Tachikawa General Hospital, Japan
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Nakayama Masafumi
Cardiovascular Center, Tachikawa General Hospital, Japan
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Tanaka Nobuhiro
Department of Cardiology, Tokyo Medical University, Japan
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