scholarly journals Torsades de pointes after prolonged intravenous amiodarone therapy for atrial fibrillation

2020 ◽  
Author(s):  
Irina Nordkin ◽  
Tatyana Levinas ◽  
Inna Rosenfeld ◽  
Majdi Halabi
Keyword(s):  
Atrial Fibrillation ◽  
Torsades De Pointes ◽  
Amiodarone Therapy ◽  
Intravenous Amiodarone

Hypersensitivity Reaction to Amiodarone in a Patient with a Previous Reaction to an lodinated Radiocontrast Agent

2007 ◽  
Vol 41 (7-8) ◽  
pp. 1310-1314 ◽  
Author(s):  
Leanne Stafford
Keyword(s):  
Atrial Fibrillation ◽  
Hypersensitivity Reaction ◽  
Product Information ◽  
Artery Bypass ◽  
Amiodarone Therapy ◽  
Class Iii ◽  
Radiocontrast Agent ◽  
Triple Vessel Disease ◽  
Intravenous Amiodarone ◽  
Previous Reaction

Objective: To describe a case of a hypersensitivity reaction to oral amiodarone in a patient with a previous reaction to an iodinated radiocontrast agent. Case Summary: A 55-year-old man experienced facial urticaria after intraarterial injection of iohexol, an iodinated radiocontrast agent, during coronary angiography, which was successfully treated with intravenous hydrocortisone and promethazine. The procedure revealed significant triple vessel disease, and the patient subsequently underwent coronary artery bypass grafting in October 2006. Postoperatively, the patient experienced 2 episodes of fast atrial fibrillation, the first of which was treated successfully with intravenous amiodarone. The second episode resulted in the commencement of therapy with oral amiodarone 400 mg 3 times daily. Within one hour after the first dose, the patient experienced tip swelling and tingling, which was again treated with intravenous promethazine. Amiodarone was stopped; the patient remained in sinus rhythm and was discharged without further incident. Discussion: Amiodarone is a class III antiarrhythmic agent frequently used in the management of atrial fibrillation after cardiac surgery. The approved product information lists known hypersensitivity to iodine as a contraindication to its administration, but no other cases of amiodarone hypersensitivity in a patient with a previous reaction to an iodinated radiocontrast agent have been published, Conversely, it has been suggested that the drug may be safely used in such patients. The Naranjo probability scale supported a probable adverse reaction of hypersensitivity associated with amiodarone therapy in this patient. Conclusions: Prescribers should exercise caution in the administration of amiodarone to patients with a true, documented history of hypersensitivity to an iodinated compound.

scholarly journals Altered Mental Status and Hyponatremia After 20 Hours of Amiodarone Therapy

2020 ◽  
Vol 47 (3) ◽  
pp. 229-232 ◽  
Author(s):  
Andrea Qi ◽  
John C. Moscona ◽  
Justin Reed ◽  
Thierry H. Le Jemtel
Keyword(s):  
Atrial Fibrillation ◽  
Emergency Department ◽  
Antidiuretic Hormone ◽  
Fluid Intake ◽  
Saline Solution ◽  
Altered Mental Status ◽  
Amiodarone Therapy ◽  
Intravenous Amiodarone ◽  
Onset Atrial Fibrillation ◽  
New Onset

A 66-year-old woman with no relevant medical history presented at the emergency department with new-onset atrial fibrillation. We initiated intravenous amiodarone therapy. At 20 hours, the patient experienced severe neurologic symptoms, hyponatremia, and syndrome of inappropriate antidiuretic hormone. We discontinued amiodarone, infused saline solution, and restricted the patient's fluid intake. She recovered in 3 days. This case illustrates that amiodarone-induced syndrome of inappropriate antidiuretic hormone with hyponatremia can occur far earlier than expected during acute amiodarone therapy.

Potentially modifiable factors of dofetilide-associated risk of torsades de pointes among hospitalized patients with atrial fibrillation

2018 ◽  
Vol 54 (2) ◽  
pp. 189-196 ◽  
Author(s):  
Niyada Naksuk ◽  
Alan M. Sugrue ◽  
Deepak Padmanabhan ◽  
Danesh Kella ◽  
Christopher V. DeSimone ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Torsades De Pointes ◽  
Hospitalized Patients ◽  
Modifiable Factors
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