Amiodarone for control of recurrent ventricular tachycardia secondary to cardiac metastasis

Metastatic tumors of the ventricles may cause symptomatic ventricular tachycardia such as described in this 66-year-old man, who presented with recurrent presyncope. The tumor may be readily diagnosed by 2-dimensional echocardiography, ultrafast computed tomography, or magnetic resonance imaging. Such tumors usually indicate an advanced stage of disease, and curative treatment is rarely possible. However, in this patient, effective control of the arrhythmia was achieved with a moderate dosage of oral amiodarone (600 mg daily for 4 weeks, then 400 mg daily), and he had no further episodes of presyncope. This report shows that the effectiveness of amiodarone in the control of symptomatic ventricular tachycardias may also extend to those that are probably secondary to metastatic tumors of the heart.