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[Amiodarone-induced torsade de pointes--five case reports].

Piotr Kukla1, Teresa Słowiak-Lewińska

  • 1Oddział Chorób Wewnetrznych z pododdziałem Kardiologii, Szpital Specjalistyczny im H. Klimontowicza, Gorlice, Poland.

Kardiologia Polska
|July 1, 2004
PubMed
Summary

This study details five patients experiencing amiodarone-induced QT prolongation and torsade de pointes. Effective treatments included beta-blockers and lidocaine, with all patients surviving initial hospital discharge.

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Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Amiodarone is an antiarrhythmic drug known to cause QT prolongation.
  • QT prolongation can lead to life-threatening ventricular arrhythmias like torsade de pointes.

Observation:

  • Five patients presented with amiodarone-induced QT prolongation and torsade de pointes.
  • Associated conditions included hypokalemia, bradycardia, and T-wave alternans.
  • Negative T waves in precordial leads indicated a higher risk of ventricular fibrillation.

Findings:

  • Beta-blockers and lidocaine demonstrated efficacy in managing these arrhythmias.
  • Tosylate bretylate was also effective in two patients.
  • All patients survived hospitalization, though one experienced a late mortality.

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Implications:

  • Understanding risk factors like T-wave morphology is crucial for managing amiodarone toxicity.
  • Prompt and appropriate antiarrhythmic therapy can improve patient outcomes.
  • Long-term monitoring may be necessary following amiodarone-induced arrhythmias.