Key result
Amiodarone treatment for one year resulted in a severe increase in atrial pacing threshold and loss of atrial capture, which normalized upon drug discontinuation.
Case Report (n=1)
Amiodarone may cause a clinically significant, reversible, and atrium-specific increase in pacing thresholds leading to loss of capture.
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Amiodarone may cause reversible atrial capture loss in paced patients; single case leaves open need for prospective confirmation before practice change.
Increases of pacing threshold stimulation are well documented with different antiarrhythmic drugs, but not with amiodarone. We report a case of a patient with dual-chamber pacing, with stable thresholds on repeated measurements on the last year, who presented severe increase of atrial pacing threshold resulting in loss of atrial capture after a year of treatment with amiodarone. Thresholds were normalized once amiodarone was removed. Ventricular thresholds were not affected.
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Grande et al. (2011) conducted a case report in Dual-chamber pacing (n=1). Amiodarone was evaluated on Atrial pacing threshold. Amiodarone treatment for one year resulted in a severe increase in atrial pacing threshold and loss of atrial capture, which normalized upon drug discontinuation.
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