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March 31, 1975

Imipramine-Induced Heart Block A Longitudinal Case Study

Author Affiliations

From the departments of medicine (Drs. Bigger and Macken), pharmacology (Dr. Perel) and psychiatry (Drs. Glassman and Kantor), College of Physicians and Surgeons, Columbia University, and the New York State Psychiatric Institute (Drs. Glassman, Kantor, and Perel), New York.

JAMA. 1975;231(13):1364-1366. doi:10.1001/jama.1975.03240250034022

A 2:1 atrioventricular block developed during treatment with the tricyclic antidepressant imipramine in a 74-year-old man with a three-year history of right bundle-branch block. Serial cardiographic studies and determinations of blood imipramine concentrations showed that the heart block was directly related to the plasma concentration of the drug and occurred below the atrioventricular node in the His-Purkinje system.

(JAMA 231:1364-1366, 1975)