• Internal medicine · Jan 2008

    Case Reports

    Severe respiratory failure and torsades de pointes induced by disopyramide in a patient with myasthenia gravis.

    • Kayo Hirose, Hiroshi Yamaguchi, Yasushi Oshima, Masahito Choraku, Akira Hirono, Nobuyuki Takamori, and Katsuya Tamura.
    • Health Insurance Naruto Hospital. rannrann5656@yahoo.co.jp
    • Intern. Med. 2008 Jan 1; 47 (19): 1703-8.

    AbstractClass 1a anti-arrhythmic drugs are often used for the treatment of atrial fibrillation (AF), but it is not well known that myasthenia gravis (MG)-like symptoms can be generated by their anti-cholinergic effects. We had a patient with MG who developed symptomatic MG aggravation after AF treatment with disopyramide. Symptomatic MG aggravation was followed by Takotsubo-shaped cardiomyopathy, QT prolongation, and torsades de pointes. We suggest that the anti-cholinergic effects of disopyramide can induce MG crisis and should therefore be carefully considered when disopyramide is used to treat AF in patients with MG.

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