Torsade de pointes induced by ajmaline

Ajmaline, a reserpine derivative, is an effective class I antiarrhythmic ag ent. Herein we report two cases of ajmaline-induced abnormal QT prolongatio n accompanied by polymorphic ventricular tachycardia of the torsade de poin tes type. Since ajmaline is increasingly used for the acute termination of wide complex tachycardia and as a diagnostic tool after syncope and in pati ents with idiopathic ventricular tachyarrhythmias, our observations suggest that caution should be exercised with regard to the effects of the drug on the QT interval and its potency to induce proarrhythmia of the torsade de pointes type.