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April 1, 2006Pacing and Clinical Electrophysiology

“Torsade de Pointes” in Patients with Structural Heart Disease and Atrial Fibrillation Treated with Amiodarone, β‐Blockers, and Digitalis

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Key result

Amiodarone loading combined with beta-blocker and digitalis therapy was associated with early Torsade de pointes tachycardia in 3 patients with structural heart disease and atrial fibrillation.

Why the study?

Does amiodarone loading combined with beta-blockers and digitalis cause Torsade de pointes in patients with structural heart disease and atrial fibrillation?

Population

3 patients with structural heart disease and tachyarrhythmic atrial fibrillation.

Design

Case_series

Follow-up

up to 48 hours

Authors

JSJan W. SchrickelUniversity Hospital BonnJSJoerg O. SchwabUniversity Hospital BonnAYAlexander YangUniversity of Alabama at Birmingham

Discussion

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Member takes

Overview

May signal heightened TdP risk with this combination in SHD and AF; hypothesis-generating and requires confirmation.

Study Design

Type

Case Report (n=3)

Structured PICO

Does amiodarone loading combined with beta-blockers and digitalis cause Torsade de pointes in patients with structural heart disease and atrial fibrillation?

P
Population
3 patients with structural heart disease (history of coronary heart disease, severely reduced LVEF in 2) and tachyarrhythmic atrial fibrillation.
I
Intervention
Amiodarone loading therapy (oral or intravenous) combined with heart rate controlling medication including a beta-blocker and digitalis.
O
Outcome
Torsade de pointes tachycardiasafety

Amiodarone loading combined with beta-blockers and digitalis may increase the risk of Torsade de pointes in patients with structural heart disease and atrial fibrillation.

Cite This Study

Schrickel et al. (2006) conducted a case report in Structural heart disease and atrial fibrillation (n=3). Amiodarone, beta-blockers, and digitalis was evaluated on Torsade de pointes tachycardia (Tdp). Amiodarone loading combined with beta-blocker and digitalis therapy was associated with early Torsade de pointes tachycardia in 3 patients with structural heart disease and atrial fibrillation.

synapsesocial.com/papers/6a1c734e4d97451bbd2fc052https://doi.org/10.1111/j.1540-8159.2006.00354.x
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Amiodarone-associated Proarrhythmic Effects: A Review with Special Reference to Torsade de Pointes Tachycardia1994 · 383 citations
  2. 2Torsade de Pointes Induced by Intravenous and Long-Term Oral Amiodarone Therapy in a Patient With Dilated Cardiomyopathy2001 · 16 citations
  3. 3Amiodarone to Prevent Recurrence of Atrial Fibrillation2000 · 1,160 citations
  4. 4Amiodarone Interaction With β-Blockers1999 · 252 citations
  5. 5Early Proarrhythmia During Intravenous Amiodarone Treatment1999 · 16 citations