TORSADE-DE-POINTES WITH AMIODARONE IN A PATIENT WITH PREVIOUS TORSADEDURING BETA-RECEPTOR BLOCKADE

Torsade de pointes is a potentially lethal ventricular arrhythmia that is associated with prolonged QT intervals and is often caused by drug s that prolong repolarization. Among the most common drugs that may ca use torsade de pointes are antiarrhythmic drugs including quinidine, p rocainamide, sotalol and newer class III antiarrhythmic agents. The in cidence of torsade de pointes associated with amiodarone, however, is reported to be much lower. A case is reported of amiodarone-induced to rsade de pointes following the development of the same arrhythmia duri ng betablocker use. This case illustrates that although the reported i ncidence of torsade de pointes during amiodarone therapy is low, patie nts with bradycardia-induced torsade de pointes may be a subgroup of p atients who are at increased risk of this arrhythmia with amiodarone.