Octreotide improved ventricular arrhythmia in an acromegalic patient

We saw a remarkable effect of octreotide, the long-acting somatostatin anal ogue, in reducing the number of ventricular premature complexes (VPCs) in a 59-year-old woman with acromegaly. Her basal GH and IGF-1 levels were up t o 22.9 ng/ml and 934.9 ng/ml respectively. MRI revealed a 14x12x10 mm mass lesion in the pituitary gland. She had hypertension and echocardiography sh owed an increase in left ventricular wall thickness. Electric cardiography showed the presence of frequent VPCs and 24-h Holter monitoring revealed 24 277 beats of multifocal VPCs/24 h. She was treated with 300 mu g/day of oct reotide for four weeks before transsphenoidal surgery. After octreotide tre atment, GH and IGF-1 were suppressed to 1.8 ng/ml and 145.3 ng/ml respectiv ely, and the tumor size was remarkably reduced. Furthermore, the number of VPCs was also dramatically reduced to 2062 VPCs/24-h (8.5% of pretreatment) with 24-h Holter monitoring. This case shows that VPCs of acromegalic pati ents can be controlled by suppressing GH and IGF-1 with octreotide, and thi s agent is useful for reducing both tumor size and frequency of VPCs prior to surgery.