Doğan, UmuttanGörmüş, NiyaziYazıcı, MehmetCan, İlknurGök, Hasan2020-03-262020-03-262010Doğan, U., Görmüş, N., Yazıcı, M., Can, İ., Gök, H., (2010). Supraventricular Tachycardia Associated with Cilostazol Use. International Journal of Cardiology, 140, 93-93. DOI: 10.1016/S0167-5273(10)70329-60167-52731874-1754https://dx.doi.org/10.1016/S0167-5273(10)70329-6https://hdl.handle.net/20.500.12395/25292Objective: We present a case of supraventricular tachycardia which might be associated with the initiation of cilostazol treatment. Methods: A 46-year old male was admitted to the outpatient clinics of the cardiology department with the complaint of sudden onset of palpitations lasting for approximately 30 minutes. He stated that though most of his episodes terminated spontaneously, he had to receive several medical interventions in the emergency department. His past medical history was remarkable for a lower extremity pain which suggested intermittant claudication. His MR-angiography of the lower extremities was consistent with a total occlusion of bilateral posterior tibial artery and right anterior tibial artery. Revascularization had not been planned due to distal arterial disease, therefore the patient was put on oral cilostazol and acetylsalicylic acid treatments. His palpitations started after the initiation of this new treatment regimen. It was also learned that the tachycardia attacks persisted after 90 mg/d diltiazem and 50 mg/d metoprolol treatments which were given to avoid the attacks. The rhythm was sinus and both the physical examination and the echocardiographic investigation were in normal range. The ECG which was obtained during the course of an tachycardia attack revealed a narrow QRS with a long RP interval. Hemogram, blood chemistry (electrolytes, kidney, liver and thyroid functions) and 24-h Holter were within normal limits. Although a further electrophysiologic study was planned, it could not be performed as the patient disagreed any other evaluation. Results: The cilastazol which is a phosphodiesterase inhibitor was discontinued and regarded as the probable precipitant of tachycardia attacks. Metoprolol 50 mg/d was continued for 3 more months. The patient did not experience any tachycardia attacks during a follow up period of 2 years. Conclusions: Cilostazol is a peculiar phosphodiesterase III inhibitor that is indicated for intermittant claudication. An increase in mean heart rate and atrioventricular nodal rhythm and sustained and non-sustained ventricular tachycardia associated with cilostazol treatment have been reported previously. These effects have been thought to originate from increased levels of cAMP as is in other phosphodiesterase inhibitors. To the best of our knowledge, the patient presented here is the first case report of a supraventricular tachycardia precipitated by cilostazol treatment. We suggest that it might be beneficial to monitorize the patients during the course of cilostazol treatment for any possible arrhythmias and it is reasonable to discontinue cilostazol in the presence of new onset arrhythmias if no other explanation is available.en10.1016/S0167-5273(10)70329-6info:eu-repo/semantics/openAccessConference Object1409393WOS:000209824900327Q1