Pilsicainide-Induced Coronary Vasospasm in a Patient With Brugada-Type Electrocardiogram A Case Report

Ayumi Goda; Takeshi Yamashita; Takeshi Kato; Akira Koike; Kouichi Sagara; Hajime Kirigaya; Haruki Itoh; Tadanori Aizawa; Long-Tai Fu

doi:10.1253/circj.69.858

Case Report

Pilsicainide-Induced Coronary Vasospasm in a Patient With Brugada-Type Electrocardiogram

A Case Report

Ayumi Goda, Takeshi Yamashita, Takeshi Kato, Akira Koike, Kouichi Sagara, Hajime Kirigaya, Haruki Itoh, Tadanori Aizawa, Long-Tai Fu

Author information

Ayumi Goda
The Cardiovascular Institute, Tokyo Medical and Dental University
Department of Cardiovascular Medicine, Tokyo Medical and Dental University
Takeshi Yamashita
The Cardiovascular Institute, Tokyo Medical and Dental University
Takeshi Kato
The Cardiovascular Institute, Tokyo Medical and Dental University
Akira Koike
The Cardiovascular Institute, Tokyo Medical and Dental University
Kouichi Sagara
The Cardiovascular Institute, Tokyo Medical and Dental University
Hajime Kirigaya
The Cardiovascular Institute, Tokyo Medical and Dental University
Haruki Itoh
The Cardiovascular Institute, Tokyo Medical and Dental University
Tadanori Aizawa
The Cardiovascular Institute, Tokyo Medical and Dental University
Long-Tai Fu
The Cardiovascular Institute, Tokyo Medical and Dental University

Keywords: Brugada-type ECG, Coronary spasm, Pilsicainide

JOURNAL FREE ACCESS

2005 Volume 69 Issue 7 Pages 858-860

DOI https://doi.org/10.1253/circj.69.858

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Abstract

A 65-year-old man with Brugada-type electrocardiogram (ECG) was admitted to our hospital for chest pain, palpitation and faintness. In the cardiac electrophysiological study, no ventricular tachyarrthymia was induced either at baseline or after pilsicainide (50 mg) infusion. Intravenous administration of pilsicainide exaggerated ST-segment elevation in V_1-4 and converted it to the coved type in V₁, accompanied by severe chest pain. Coronary angiography revealed the vasospasm of the right coronary artery was induced by pilsicainide, not by ergonovine. This is the first case report of coronary vasospasm induced by a pure sodium channel blocker in a patient with Brugada-type ECG. (Circ J 2005; 69: 858 - 860)

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