Reactions 431 - 12 Dec 1992

★ SDesipramine overdose

First report of sustained monomorphic ventriculartachycardia: case report

Sustained monomorphic ventricular tachycardia persistedfor 72 hours in a patient who had taken an overdose ofdesipramine. The 31-year-old man, who was being treated fordepression, had ingested an unknown quantity ofdesipramine. On admission to hospital (interval not stated),the patient had a heart rate of 160 beats/min. ECG revealed aregular rhythm with no P waves and a wide QRS complex withright bundle branch block. He was treated with oral charcoal,magnesium carbonate, IV furosemide and IV infusion ofbicarbonate-containing fluids. 24 hours later, the patient’s HRwas 180 beats/min; this did not respond to carotid sinusmassage and IV metoprolol 1mg. His HR continued to rise andhe showed signs of hypoperfusion. The arrhythmia persistedfor a further 48 hours Intracardiac recordings showedatrioventricular dissociation which was successfully treatedwith ventricular overdrive burst pacing.

Author comment: To the authors’ knowledge, this is the firstreport of sustained monomorphic ventricular tachycardiafollowing tricyclic antidepressant overdosePeters RW, et al. Tricyclic overdose causing sustained monomorphic ventriculartachycardia. American Journal of Cardiology 70: 1226-1228, 1 Nov 1992 -USA 800168297

1

Reactions 12 Dec 1992 No. 4310114-9954/10/0431-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved