Why the study?
In acute heart failure, worsening congestion often impairs hepatorenal function, which can increase the risk of proarrhythmia through altered drug metabolism.
Careful evaluation of liver and renal function is mandatory to prevent proarrhythmia when using amiodarone in patients with acute heart failure.
Amiodarone loading may provoke VT/VF in acute HF; this case report leaves open the role of organ dysfunction.
The deterioration of hepatorenal function due to worsening congestion is relatively common in acute heart failure and carries an independent adverse prognosis. In some patients, the risk of proarrhythmia is increased due to impaired drug metabolism. We described a patient with acute heart failure, polymorphic ventricular tachycardia (VT), and ventricular fibrillation episodes while receiving loading doses of amiodarone for atrial fibrillation. The occurrence of arrhythmia at the background therapy with a relatively safe antiarrhythmic drug in the settings of moderate cardiac, renal, and borderline liver functional impairment demonstrates that careful evaluation of liver and renal function is mandatory for the prevention of proarrhythmia.
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Semerdzhieva et al. (2021) studied this question.
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