Intravenous amiodarone can induce incessant monomorphic ventricular tachycardia as a rare proarrhythmic effect in patients with structural heart disease.
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May signal rare IV amiodarone proarrhythmia in structural heart disease; hypothesis-generating for nifekalant termination, pending prospective data.
This case report describes incessant monomorphic ventricular tachycardia (VT), not torsade de pointes, induced by intravenous amiodarone in a 48-year-old woman with dilated cardiomyopathy. VT was reproducibly triggered by short coupled premature ventricular complex (PVC) with different morphology from VT. After amiodarone infusion, the coupling interval of initiating PVC was prolonged, and moreover, the morphology of initiating PVC became the same as that of VT. Though amiodarone has become the first line drug to treat ventricular tachyarrhythmias in patients with cardiac dysfunction, it is important to be aware of its proarrhythmic effect, which may lead to an electrical storm of monomorphic VT.
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Makimoto et al. (2011) studied this question.
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