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Amiodarone-induced sudden onset of polymorphic ventricular tachycardia following dislodgement of a temporary pacemaker: a case report

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Abstract

Amiodarone is commonly used to instantly reverse potentially fatal myocardial arrhythmias, but may also potentiate arrhythmic adverse effects, such as QT prolongation and torsades de pointes. This case describes a 56-year-old male patient who, after experiencing a myocardial infarction, had undergone temporary pacemaker (TPM) insertion for bradycardia-induced ventricular tachycardia (VT); however, his VT persisted post-insertion and intravenous amiodarone was administered. Within a few minutes, monomorphic VT occurred, which progressed to polymorphic VT arrest (i.e. torsades de pointes). The polymorphic VT induced by amiodarone resolved on withdrawal of amiodarone and a subsequent switch to lignocaine. In view of suspected TPM dislodgement, a new TPM was inserted and paced at a higher rate. The patient did not show further ventricular arrhythmia and, prior to discharge, had a permanent pacemaker implanted and was hemodynamically stable.

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Acknowledgements

The authors thank the staff nurses of the coronary care unit, headed by Ms Siti Nordiyana, who took care of the patient during admission, and the Clinical Research Department, assisted by Ms Norfazlina, for facilitating the provision of the required information.

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Authors and Affiliations

  1. International Medical University (IMU), 126, Jln Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia

    Aminah Mazyin Mohamed Ariff

  2. National Heart Institute (IJN), 145, Jalan Tun Razak, 50400, Kuala Lumpur, Malaysia

    Hafidz Abd Hadi, Nay Thu Win, Mohamed Imran Thoulath, Subashini Muthiah Mutaya & Ahmad Khairuddin Mohamed Yusof

Authors
  1. Aminah Mazyin Mohamed Ariff
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  2. Hafidz Abd Hadi
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  3. Nay Thu Win
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  4. Mohamed Imran Thoulath
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  5. Subashini Muthiah Mutaya
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  6. Ahmad Khairuddin Mohamed Yusof
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Contributions

AMMA wrote the original manuscript, researched the topic and collected the data; HAH, NTW, MIT and SMM helped with the research; AKMY supervised and coordinated the case report; and HAH and AKMY edited the manuscript.

Corresponding author

Correspondence to Aminah Mazyin Mohamed Ariff.

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Funding

No sources of funding were used.

Conflict of interest

Aminah Mazyin Mohamed Ariff, Hafidz Abd Hadi, Nay Thu Win, Mohamed Imran Thoulath, Subashini Muthiah Mutaya and Ahmad Khairuddin Mohamed Yusof have no relevant conflicts of interest to declare.

Ethical approval

This study was conducted in full conformance with the principles of the Declaration of Helsinki, Good Clinical Practice, and within the laws and regulations of the country in which the research was conducted.

Patient consent

Data are anonymized. General informed consent for utilizing data for research purposes was obtained for all patients of the National Heart Institute (IJN), Kuala Lumpur, Malaysia.

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Mohamed Ariff, A.M., Abd Hadi, H., Win, N.T. et al. Amiodarone-induced sudden onset of polymorphic ventricular tachycardia following dislodgement of a temporary pacemaker: a case report. Drugs Ther Perspect 36, 263–265 (2020). https://doi.org/10.1007/s40267-020-00729-7

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  • DOI: https://doi.org/10.1007/s40267-020-00729-7

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