Torsade de pointes ventricular tachycardia during low dose intermittent dobutamine treatment in a patient with dilated cardiomyopathy and congestive heart failure

The authors describe the case of a 56-year-old woman with chronic, severe h eart failure secondary to dilated cardiomyopathy and absence of significant ventricular arrhythmias who developed QT prolongation and torsade de point es ventricular tachycardia during one cycle of intermittent low dose (2.5 m cg/kg per min) dobutamine. This report of torsade de pointes ventricular ta chycardia during intermittent dobutamine supports the hypothesis that unpre dictable fatal arrhythmias map occur even with low doses and in patients wi th no history of significant rhythm disturbances. The mechanisms of proarrh ythmic effects of Dubutamine are discussed.