A case of drug-induced interstitial pneumonia caused by repeated exposure to bepridil

• Published in: Journal of Arrhythmia 2013-02, Vol.29 (1), p.39-42
• Main Authors: Yokoi, Kensuke, Yada, Hirotaka, Yoshimoto, Daisuke, Hakuno, Daihiko, Miyazaki, Koji, Adachi, Takeshi
• Format: Article
• Language: English
• Subjects: Ablation; Ablation (Surgery); Atrial fibrillation; Bacterial pneumonia; Bepridil; Cardiac arrhythmia; Cardiac patients; Cardiovascular; Catheters; Corticosteroids; Drug dosages; Drug therapy; Dyspnea; Health aspects; Heart; Heart failure; Hospitalization; Interstitial pneumonia; Lung diseases; Lymphocytes; Pleural effusion; Pneumonia; Proteins; Pulmonary arteries; Pulmonary fibrosis; Radiography; Sinuses; Surfactants; Tomography; Toxicity
• ISSN: 1880-4276; 1883-2148
• DOI: 10.1016/j.joa.2012.09.005

Abstract The patient was a 78-year-old man. In August 2007, he underwent catheter ablation for atrial fibrillation after taking bepridil for 3 weeks. Soon after the ablation, he experienced frequent atrial extrasystoles and began taking bepridil again on the day he left the hospital. Six days after discharge, he was readmitted to our hospital with dyspnea and was diagnosed with acute heart failure. The patient had no recurrence of atrial fibrillation, so the administration of bepridil was stopped. His dyspnea was eased using standard therapy for heart failure and he was discharged from our hospital. In March 2011, he had a recurrence of atrial fibrillation and was readmitted to our hospital. The administration of bepridil was initiated to defibrillate the atrial fibrillation. Although bepridil stopped the atrial fibrillation by the third day, he presented with dyspnea and fever on the fourth day. A chest radiograph showed bilateral interstitial patterns that radiated from the pulmonary hilum. He was treated for acute heart failure and bacterial pneumonia, but this was ineffective. We suspected that the interstitial pneumonia was caused by bepridil. Corticosteroid therapy dramatically improved his symptoms. This was a rare case of acute drug-induced interstitial pneumonia caused by repeated exposure to bepridil.