A Perfect Storm: Tyrosine Kinase Inhibitor-Associated Polymorphic Ventricular Tachycardia

Document Type

Article

Publication Date

4-1-2017

Publication Title

The Journal of emergency medicine

Abstract

BACKGROUND: Oral tyrosine kinase inhibitors (TKIs) are becoming increasingly common in oncology practice due to ease of administration and patient preference. This class of medications is relatively unknown to emergency physicians.

CASE REPORT: Here we present a case of electrical storm (ES) thought to be associated with ibrutinib, a TKI. The ES was unabated despite antidysrhythmic therapy and electrical cardioversion, and was treated with supportive care, which eventually included the use of extracorporeal membrane oxygenation. This patient had no risk factors or apparent causes of recurrent ventricular tachycardia. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: ES has not previously been described with ibrutinib, but may be associated with off-target effects of the drug.

Medical Subject Headings

Adenine/analogs & derivatives; Amiodarone/pharmacology/therapeutic use; Anti-Arrhythmia Agents/pharmacology/therapeutic use; Antineoplastic Agents/adverse effects/pharmacology/therapeutic use; Cardiotonic Agents/pharmacology/therapeutic use; Electric Countershock/methods; Electrocardiography/methods; Electrophysiology/methods; Emergency Service; Hospital/organization & administration; Extracorporeal Membrane Oxygenation/methods; Humans; Intensive Care Units/organization & administration; Intra-Aortic Balloon Pumping/methods; Isoproterenol/pharmacology/therapeutic use; Lidocaine/pharmacology/therapeutic use; Magnesium/pharmacology/therapeutic use; Male; Middle Aged; Piperidines; Pyrazoles/adverse effects/pharmacology/therapeutic use; Pyrimidines/adverse effects/pharmacology/therapeutic use; Respiration; Artificial/methods; Syncope/etiology; Tachycardia; Ventricular/diagnosis/etiology/therapy; Torsades de Pointes/diagnosis/drug therapy; Waldenstrom Macroglobulinemia/drug therapy; Workforce; dysrhythmia; electrical storm; ibrutinib; torsades des pointes; tyrosine kinase inhibitor; ventricular storm

PubMed ID

28007361

Volume

52

Issue

4

First Page

123

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