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Sequeira OR, Aquino NJ, Gómez NB, et al. Amiodarone-Induced Third Degree Atrioventricular Block and Extreme QT Prolongation Generating Torsade Des Pointes in Paroxysmal Atrial Fibrillation. J Atr Fibrillation. 2016;9(3):1502doi: 10.4022/jafib.1502.
Sequeira, O. R., Aquino, N. J., Gómez, N. B., García, L. B., Cáceres, C., Lovera, O. A., & Centurión, O. A. (2016). Amiodarone-Induced Third Degree Atrioventricular Block and Extreme QT Prolongation Generating Torsade Des Pointes in Paroxysmal Atrial Fibrillation. Journal of atrial fibrillation, 9(3), 1502. https://doi.org/10.4022/jafib.1502
Sequeira, Orlando Robert, et al. "Amiodarone-Induced Third Degree Atrioventricular Block and Extreme QT Prolongation Generating Torsade Des Pointes in Paroxysmal Atrial Fibrillation." Journal of atrial fibrillation vol. 9,3 (2016): 1502. doi: https://doi.org/10.4022/jafib.1502
Sequeira OR, Aquino NJ, Gómez NB, García LB, Cáceres C, Lovera OA, Centurión OA. Amiodarone-Induced Third Degree Atrioventricular Block and Extreme QT Prolongation Generating Torsade Des Pointes in Paroxysmal Atrial Fibrillation. J Atr Fibrillation. 2016 Oct 31;9(3):1502. doi: 10.4022/jafib.1502. eCollection 2016. PMID: 28496937; PMCID: PMC5368557.
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J Atr Fibrillation. 2016 Oct 31;9(3):1502. doi: 10.4022/jafib.1502. eCollection 2016.

Amiodarone-Induced Third Degree Atrioventricular Block and Extreme QT Prolongation Generating Torsade Des Pointes in Paroxysmal Atrial Fibrillation.

Journal of atrial fibrillation

Orlando Robert Sequeira, Nelson Javier Aquino, Nancy Beatriz Gómez, Laura Beatriz García, Cristina Cáceres, Oscar A Lovera, Osmar Antonio Centurión

Affiliations

  1. Department of Health Sciences's Investigation. Sanatorio Metropolitano. Fernando de la Mora. Paraguay. Cardiology Department, Clinic Hospital, Asunción National University, San Lorenzo, Paraguay.

PMID: 28496937 PMCID: PMC5368557 DOI: 10.4022/jafib.1502

Abstract

Amiodarone is still the most potent antiarrhythmic drug in the prevention of life threatening ventricular arrhythmias and demonstrates a very low incidence of torsade de pointes. An unusual case of an 81-year-old woman who developed serious abnormalities of the conduction system of the heart and torsade des pointes during intravenous infusion of amiodarone for the treatment of paroxysmal atrial fibrillation is described. To the best of our knowledge, this is the first case showing an association of intravenous amiodarone-induced third degree atrioventricular block and extreme QT interval prolongation generating torsade des pointes in a patient with paroxysmal atrial fibrillation who required an implantable cardioverter-defibrillator. Currently, amiodarone is still one of the few remaining treatment options for the medical therapeutic management of serious ventricular arrhythmias and to reduce the incidence of atrial fibrillation without increasing mortality or sudden cardiac death rates in heart failure patients like our elderly present patient. Nevertheless, we have to keep in mind that intravenous amiodarone may generate serious abnormalities of the conduction system of the heart and lethal ventricular arrhythmias in certain patients.

Keywords: Amiodarone; Implantable Cardioverter-Defibrillator; Paroxysmal Atrial Fibrillation; QT Interval Prolongation; Third Degree AV Block; Torsade Des Pointes

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