Ajmaline (AML)

Ajmaline is an alkaloid that is class Ia antiarrhythmic agent. It is often used to bring out typical findings of ST elevations in patients suspected of having Brugada syndrome. The compound was first isolated by Salimuzzaman Siddiqui in 1931 from the roots of Rauwolfia serpentina. Ajmaline, a reserpine derivative, is an effective class I antiarrhythmic agent. Two cases of ajmaline-induced abnormal QT prolongation accompanied by polymorphic ventricular tachycardia of the torsade de pointes type. Since ajmaline is increasingly used for the acute termination of wide complex tachycardia and as a diagnostic tool after syncope and in patients with idiopathic ventricular tachyarrhythmias, 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.