Intracoronary electrocardiogram during torsade des pointes secondary to intracoronary papaverine

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Abstract
Papaverine, a potent coronary vasodilator, is now commonly used to measure coronary reserve. We recorded intracoronary etectrogram in a patient who developed Torsade des pointes after 10 mg of papaverine. This was associated with marked prolongation of the QT interval. The ventricular tachycardia self‐terminated with shortening of the QT interval. We believe that although papaverine is a good agent because of its short duration of action, it must be used cautiously because of its effects on repolarization, which can result in arrhythmias.