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Case Reports
. 2022 Jul;27(4):e12936.
doi: 10.1111/anec.12936. Epub 2022 Mar 24.

Torsade de pointes caused by citalopram during the pacemaker battery-depletion phase: A case report

Junwen Wang  1 , Ziyi Sun  2 , Siming Tao  1
Affiliations
Case Reports

Torsade de pointes caused by citalopram during the pacemaker battery-depletion phase: A case report

Junwen Wang et al. Ann Noninvasive Electrocardiol. 2022 Jul.

Abstract

Drug-induced QT prolongation, primarily antiarrhythmic drugs, is a common cause of torsade de pointes (TdP). Although there have been previous reports of drug-induced TdP in patients, it has not been well documented when caused by citalopram during the pacemaker battery-depletion phase. To improve delirium recognition, we report a case of citalopram-induced TdP during the pacemaker battery-depletion phase. An 84-year-old Chinese female was brought to the hospital presenting recurrent syncope. She lost consciousness and was admitted after her syncope TdP was documented. Her pacemaker was inspected and found to be operating in an extremely ineffective manner. Although she had prolonged QT interval after the pacemaker was replaced, she did not suffer another syncope attack, and ECG monitoring revealed no cardiac arrhythmia or TdP. During her admission, she was treated with citalopram for depression. Citalopram was discontinued when the QT interval shortened progressively. In this study, we described a case of citalopram-induced TdP during the depletion phase of a pacemaker battery. This case should serve as a cautionary lesson to clinicians to avoid using citalopram during the pacemaker battery-depletion phase.

Keywords: case report; citalopram; pacemaker battery depletion; torsade de pointes.

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Conflict of interest statement

There are no conflicts of interest reported by any of the authors in relation to the research, authorship, and/or publication of this article.

Figures

FIGURE 1
FIGURE 1
Electrocardiogram showing that torsade de pointes was an induced phenomenon of R on T
FIGURE 2
FIGURE 2
The new pacemaker was placed
FIGURE 3
FIGURE 3
The re‐examined electrocardiogram revealed heart rate recovery and QT interval prolongation after pacemaker replacement
FIGURE 4
FIGURE 4
The QT interval was significantly shortened before discharge
See this image and copyright information in PMC

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