{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T18:05:55Z","timestamp":1760551555796,"version":"3.37.3"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T00:00:00Z","timestamp":1634083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T00:00:00Z","timestamp":1634083200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["JA Clin Rep"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Several types of antiarrhythmic drugs are known to induce QT prolongation and torsades de pointes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>An 84-year-old man was scheduled for open gastrectomy for residual cancer. He had been prescribed bepridil for atrial fibrillation that converted to sinus rhythm with prolonged QT interval in the operating room. After the surgery was initiated under general and epidural anesthesia, the patient\u2019s heart rate decreased to 50\/min and multifocal premature ventricular contractions appeared, followed by several episodes of torsades de pointes, each lasting for 5 to 15\u2009s. Infusion of isoproterenol was started (0.01\u2009\u03bcg\/kg\/min), and the heart rate was maintained at around 80\/min. Premature ventricular contractions disappeared, and torsades de pointes did not recur during the surgery. The operation was completed uneventfully. The serum bepridil concentration was found to be extremely high postoperatively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Bepridil-induced intraoperative episodes of torsades de pointes were successfully treated by increasing the heart rate with isoproterenol.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40981-021-00475-3","type":"journal-article","created":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T11:32:47Z","timestamp":1634124767000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Successful treatment of bepridil-induced intraoperative torsades de pointes by isoproterenol infusion"],"prefix":"10.1186","volume":"7","author":[{"given":"Ken","family":"Shimano","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyungho","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiki","family":"Hara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Yasuda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8505-3851","authenticated-orcid":false,"given":"Shigehito","family":"Sawamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,10,13]]},"reference":[{"key":"475_CR1","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1253\/circj.69.44","volume":"69","author":"Y Nakazato","year":"2005","unstructured":"Nakazato Y, Yasuda M, Sasaki A, Iida Y, Kawano Y, Nakazato K, et al. Conversion and maintenance of sinus rhythm by bepridil in patients with persistent atrial fibrillation. Circ J. 2005;69:44\u20138. https:\/\/doi.org\/10.1253\/circj.69.44.","journal-title":"Circ J"},{"key":"475_CR2","doi-asserted-by":"publisher","first-page":"1020","DOI":"10.1253\/circj.cj-08-1061","volume":"73","author":"T Yamashita","year":"2009","unstructured":"Yamashita T, Ogawa S, Sato T, Aizawa Y, Atarashi H, Fujiki A, et al. Dose-response effects of bepridil in patients with persistent atrial fibrillation monitored with transtelephonic electrocardiograms\u202f: a multicenter, randomized, placebo-controlled, double-blind study (J-BAF Study). Circ J. 2009;73:1020\u20137. https:\/\/doi.org\/10.1253\/circj.cj-08-1061.","journal-title":"Circ J"},{"key":"475_CR3","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1253\/circj.70.662","volume":"70","author":"M Yasuda","year":"2006","unstructured":"Yasuda M, Nakazato Y, Sasaki A, Kawano Y, Nakazato K, Tokano T, et al. Clinical evaluation of adverse effects during bepridil administration for atrial fibrillation and flutter. Circ J. 2006;70:662\u20136. https:\/\/doi.org\/10.1253\/circj.70.662.","journal-title":"Circ J"},{"issue":"1","key":"475_CR4","doi-asserted-by":"publisher","first-page":"63","DOI":"10.5414\/CP203843","volume":"59","author":"K Matsui","year":"2021","unstructured":"Matsui K, Mukai Y, Sakakura K, Wada K, Nakamura T, Kawabata A, et al. Relationship between serum bepridil concentration and corrected QT interval. Int J Clin Pharmacol Ther. 2021;59(1):63\u201370. https:\/\/doi.org\/10.5414\/CP203843.","journal-title":"Int J Clin Pharmacol Ther"},{"issue":"3","key":"475_CR5","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1213\/ANE.0b013e318290c380","volume":"117","author":"J Johnston","year":"2013","unstructured":"Johnston J, Pal S, Nagele P. Perioperative torsade de pointes: a systematic review of published case reports. Anesth Analg. 2013;117(3):559\u201364. https:\/\/doi.org\/10.1213\/ANE.0b013e318290c380.","journal-title":"Anesth Analg"},{"key":"475_CR6","doi-asserted-by":"publisher","first-page":"521","DOI":"10.3918\/jsicm.21.521","volume":"21","author":"S Sonobe","year":"2014","unstructured":"Sonobe S, Imashuku Y, Yoshima Y, Sukenaga C, Inamori M, Yubata K, et al. Successful use of isoproterenol for bepridil hydrochloride-induced torsades de pointes. J Jpn Soc Intensive Care Med. 2014;21:521\u20132.","journal-title":"J Jpn Soc Intensive Care Med"},{"issue":"6","key":"475_CR7","doi-asserted-by":"publisher","first-page":"754","DOI":"10.11281\/shinzo.43.754","volume":"43","author":"H Shiraishi","year":"2011","unstructured":"Shiraishi H, Kuroyanagi A, Shirayama T, Nakamura T, Yamano T, Matsumuro A, et al. A case of transient torsades de pointes after sinus conversion with bepridil administration for persistent atrial fibrillation. Shinzo. 2011;43(6):754\u20139. https:\/\/doi.org\/10.11281\/shinzo.43.754.","journal-title":"Shinzo"},{"issue":"3","key":"475_CR8","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1213\/ANE.0b013e3181cde713","volume":"110","author":"S Nakao","year":"2010","unstructured":"Nakao S, Hatano K, Sumi C, Masuzawa M, Sakamoto S, Ikeda S, et al. Sevoflurane causes greater QTc interval prolongation in elderly patients than in younger patients. Anesth Analg. 2010;110(3):775\u20139. https:\/\/doi.org\/10.1213\/ANE.0b013e3181cde713.","journal-title":"Anesth Analg"}],"container-title":["JA Clinical Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-021-00475-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40981-021-00475-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-021-00475-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T12:00:50Z","timestamp":1634126450000},"score":1,"resource":{"primary":{"URL":"https:\/\/jaclinicalreports.springeropen.com\/articles\/10.1186\/s40981-021-00475-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,13]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["475"],"URL":"https:\/\/doi.org\/10.1186\/s40981-021-00475-3","relation":{},"ISSN":["2363-9024"],"issn-type":[{"type":"electronic","value":"2363-9024"}],"subject":[],"published":{"date-parts":[[2021,10,13]]},"assertion":[{"value":"18 August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 September 2021","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 September 2021","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 October 2021","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This case report was exempted from institutional review board approval.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for the publication of this case report and accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"76"}}