'Torsade de pointes' during amiodarone infusion in a cirrhotic woman with a prolonged QT interval
| Autor: | Andrea Zambruni, E. Bracci, Franco Trevisani, Barbara Benazzi, Mauro Bernardi, P. Zappoli, A. Di Micoli, Marco Zoli, Annalisa Berzigotti |
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| Přispěvatelé: | Di Micoli A, Zambruni A, Bracci E, Benazzi B, Zappoli P, Berzigotti A, Zoli M, Bernardi M, Trevisani F. |
| Rok vydání: | 2009 |
| Předmět: |
Tachycardia
medicine.medical_specialty medicine.medical_treatment Cardioversion Amiodarone QT interval Torsades de Pointes Internal medicine Atrial Fibrillation Tachycardia Supraventricular Humans Medicine Repolarization Sinus rhythm CIRRHOSIS TORSADE DE POINTE Aged Hepatology business.industry QT INTERVAL Gastroenterology CIRRHOTIC CARDIOMYOPATHY Atrial fibrillation medicine.disease Cirrhotic cardiomyopathy AMIODARONE Hepatic Encephalopathy Anesthesia Cardiology Female medicine.symptom business Anti-Arrhythmia Agents medicine.drug |
| Zdroj: | Digestive and Liver Disease. 41:535-538 |
| ISSN: | 1590-8658 |
| DOI: | 10.1016/j.dld.2007.11.017 |
| Popis: | We describe an interesting case of a woman with decompensated cirrhosis, ischaemic heart disease and prolonged QT interval, who developed a new-onset atrial fibrillation. During amiodarone infusion a torsade de pointes occurred, which was immediately converted to sinus rhythm by synchronized cardioversion. A new episode of atrial fibrillation was treated with infusion of a beta-blocker (metoprolol) that restored sinus rhythm and normalized the QT interval. Delayed repolarization, frequently observed in ischaemic heart disease, cirrhosis and pro-arrhythmic drugs administration, represents the background for the development of torsade de pointes. Our report underlines that the potential harmfulness of a prolonged QT interval in cirrhotic patients is currently not perceived in its entirety, so that various categories of drugs affecting ventricular repolarization are rather thoughtlessly used in clinical practice without monitoring the QT interval. Thus, amiodarone should be avoided, if possible, or used with extreme care in arrhythmic patients with advanced liver disease. Moreover, beta-blockers may be considered the first-line treatment for rate-control during supraventricular tachyarrhythmias in cirrhotic patients with delayed repolarization. |
| Databáze: | OpenAIRE |
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