Mesh : Aged, 80 and over Alzheimer Disease / drug therapy Cardiopulmonary Resuscitation Donepezil Electrocardiography Female Humans Indans / administration & dosage adverse effects Long QT Syndrome / chemically induced Nootropic Agents / administration & dosage adverse effects Piperidines / administration & dosage adverse effects Seizures / chemically induced Syncope / chemically induced therapy Torsades de Pointes / chemically induced

来  源:   DOI:10.1136/bcr-2015-211900

Abstract:
An 80-year-old woman with Alzheimer\'s dementia presented with diarrhoea, vomiting and worsening confusion following an increase in donepezil dose from 5 to 10 mg. The ECG revealed prolongation of QTc interval. Soon after admission, she became unresponsive with polymorphic ventricular tachycardia (VT). Cardiopulmonary resuscitation with a 200 J shock was successful in establishing cardiac output. Following the discontinuation of donepezil, the QTc interval normalised and no further arrhythmias were recorded. Treatment with anticholinesterase inhibitors may result in life-threatening VT. Vigilance is required for the identification of this condition in patients presenting with presyncope, syncope or seizures.
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