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[Proarrhythmia caused by amiodarone].

L Pagano¹, R Della Monica, M Malinconico

¹Reparto di Cardiologia, Ospedale S. Maria Incoronata dell'Olmo, Cava dei Tirreni, Salerno, Italy.

Minerva Cardioangiologica

|December 6, 2001

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A patient on intravenous amiodarone for atrial tachycardia experienced torsade de pointes. This suggests genetic factors may predispose individuals to proarrhythmic effects, even with minimal QT interval changes.

Area of Science:

Cardiology
Pharmacology
Genetics

Background:

Atrial tachycardia management often involves antiarrhythmic drugs like amiodarone.
Intravenous amiodarone is used for rapid control of tachyarrhythmias.
Mitral prosthesis patients may have complex cardiac conditions.

Observation:

A patient with a mitral prosthesis developed torsade de pointes (TdP) after receiving intravenous amiodarone.
The TdP episodes occurred despite modest QT interval changes and not necessarily high drug plasma concentrations.

Findings:

Torsade de pointes can occur with amiodarone therapy even without significant QT prolongation.
This case highlights a potential link between genetic predisposition and drug-induced proarrhythmic events.
Individual susceptibility to antiarrhythmic drugs may involve altered drug metabolism or organ sensitivity.

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Implications:

Genetic screening might be beneficial for patients receiving amiodarone, especially those with cardiac implants.
Understanding genetic factors can help personalize antiarrhythmic drug therapy to minimize risks.
Further research is needed to identify specific genetic markers associated with amiodarone-induced TdP.