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Triplets in Tandem.

Swasthi S Kumar1, Sudipta Mondal1, Narayanan Namboodiri1

  • 1Department of Cardiology, Electrophysiology division, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala 695011, India.

Journal of Electrocardiology
|April 25, 2025
PubMed
Summary
This summary is machine-generated.

A patient with heart failure experienced a rare side effect of amiodarone infusion: grouped beating in triplets. This electrocardiogram finding suggests a specific drug-induced arrhythmia.

Keywords:
Echo beatEscape echo bigeminyEscape echo tripletsJunctional rhythmTriplets

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Area of Science:

  • Cardiology
  • Clinical Electrophysiology
  • Pharmacology

Background:

  • Ischemic cardiomyopathy and severe left ventricular dysfunction can predispose patients to arrhythmias.
  • Acute decompensated heart failure often requires aggressive management, including antiarrhythmic medications.
  • Ventricular tachycardia (VT) is a potentially life-threatening arrhythmia requiring prompt treatment.

Purpose of the Study:

  • To present a case of a rare electrocardiogram finding in a patient treated with amiodarone.
  • To highlight the diagnostic challenge posed by amiodarone-induced arrhythmias.
  • To discuss the clinical implications of grouped beating in triplets.

Main Methods:

  • Case report of an elderly male patient with ischemic cardiomyopathy.
  • Management of acute decompensated heart failure and recurrent ventricular tachycardia.
  • Administration of amiodarone infusion and subsequent electrocardiogram monitoring.

Main Results:

  • Cardioversion successfully restored sinus rhythm.
  • Amiodarone infusion led to the development of grouped beating in triplets on cardiac monitoring.
  • A 12-lead electrocardiogram confirmed the presence of this unique rhythm.

Conclusions:

  • Grouped beating in triplets following amiodarone infusion may represent a specific proarrhythmic effect.
  • This finding necessitates careful electrocardiogram interpretation in patients receiving amiodarone.
  • Further investigation into the mechanisms of amiodarone-induced arrhythmias is warranted.