Torsades de Pointes ventricular tachycardia induced by mosapride and flecainide in the presence of hypokalemia

We report a 68-year-old man who developed torsades de pointes ventricular t achycardia induced by combined use of mosapride and flecainide. He had a pe rmanent pacemaker (DDD mode) implanted because of sick sinus syndrome (brad ytachy syndrome) 6 years earlier. The patient had started taking mosapride for upper abdominal discomfort 2 weeks earlier. On admission, ECG showed pr olongation of the QTc interval from 0.48 to 0.56 seconds and self-terminati ng torsades de pointes occurred. We considered that this proarrhythmia was induced by mosapride in combination with antiarrhythmic agents.