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November 15, 2007EP EuropaceOpen Access

Amiodarone-associated macroscopic T-wave alternans and torsade de pointes unmasking the inherited long QT syndrome

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Population

62-year-old male patient with new-onset atrial fibrillation and a rapid ventricular response, without…

Design

Case_report

Authors

FWFlorian WegenerJEJoachim R. EhrlichSHS. H. Hohnloser

Discussion

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Overview

Amiodarone-related TdP despite normal baseline QTc warrants caution for concealed LQTS; this case leaves open whether KCNE2 screening should inform antiarrhythmic selection.

Structured PICO

P
Population
62-year-old male patient with new-onset atrial fibrillation and a rapid ventricular response, without previously documented QT prolongation or ventricular tachyarrhythmias
I
Intervention
Intravenous amiodarone (total dose 3.0 g over 48 h)
O
Outcome
Development of massive QTc prolongation, macroscopic T-wave alternans, torsade de pointes, and ventricular fibrillationsafety

A normal baseline electrocardiogram does not exclude the risk of proarrhythmic events during antiarrhythmic therapy, as drugs like amiodarone can unmask clinically inapparent congenital long QT syndrome.

Cite This Study

Wegener et al. (2007) studied this question.

synapsesocial.com/papers/6a7a9dcda51ded8e7b32d153https://doi.org/10.1093/europace/eum252
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Also Consider

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

  1. 1Genetic aspects in acquired long QT syndrome ? a piece in the puzzle2001 · 7 citations
  2. 2Causes and Management of Drug-Induced Long Qt Syndrome2010 · 59 citations
  3. 3Torsade de pointes2003 · 86 citations
  4. 4Early Afterdepolarizations, U Waves, and Torsades de Pointes2002 · 37 citations
  5. 5Current concepts in the management of long QT syndrome2002 · 9 citations