Antiarrhythmic Medication Induced Multi-Organ Dysfunction

Propafenone is a Class 1 C drug indicated for reduction of episodes of paroxysmal atrial fibrillation. There is a paucity of literature to guide the escalation of propafenone in a patient who has been on long-term therapy. Multi-organ toxicity following dose escalation within the recommended therapeutic dose range appears to be a rare event. We report a patient who presented with severe systolic heart failure six weeks after propafenone dose escalation. We discontinued propafenone therapy and the patient had full clinical and echocardiographic recovery.