Amiodarone distribution in human tissues after long-term therapy: a case of arrhythmogenic right ventricular cardiomyopathy

Hosaka, Fumitaka; Shiga, Tsuyoshi; Sakomura, Yasunari; Wakaumi, Michi; Matsuda, Naoki; Kasanuki, Hiroshi

doi:10.1007/s003800200012

Cited by 7 publications

(5 citation statements)

References 10 publications

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“…Due to the accumulation of the drug and its metabolites in the body, AIT can develop during the administration of the drug or up to several months after the withdrawal of this medication. 6 There are two mechanisms involved in AIT: Accumulation of a large amount of iodine in the gland of a patient with latent Graves’ disease, or even in a previously normal gland, can lead to the development of Type I AIT. This is called the Jod–Basedow effect.…”

Section: Discussionmentioning

confidence: 99%

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Dysfunction of the thyroid gland during amiodarone therapy: a study of 297 cases

Czarnywojtek

Płazińska

Zgorzalewicz-Stachowiak³

et al. 2016

TCRM

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AimThis study aims to explore and compare the efficacy of radioiodine treatment (RIT) in hyperthyroid and euthyroid patients who have been treated with amiodarone (AM) in the past or are currently undergoing AM treatment. Clinical observation of a group of patients with amiodarone-induced hypothyroidism during a 12-month follow-up period was used for comparison.DesignThis was a observational, two-centered study. Patients were assessed at baseline and at 2 months, 6 months, 8 months, and 12 months after RIT.PatientsGroup A: At baseline (61 males [M] and 17 females [F], mean age 50±19 years), there were 78 euthyroid patients with cardiac arrhythmias, who were treated with AM and developed amiodarone-induced thyrotoxicosis, and currently require retreatment with AM. Group B: Hyperthyroid patients (92 M and 26 F, mean age 72±11.8 years) after AM therapy in the past. Group C: Hyperthyroid patients (66 M and 13 F, mean age 63.9±13.2 years) currently treated by AM. Group D: Hypothyroid patients (6 M and 16 F, mean age 61.4±10.4 years) after AM therapy. The patients from Groups A, B, and C were retreated with AM after ~3–6 weeks of RIT.ResultsIn Group A, after 12 months of RIT therapy, recurrent thyrotoxicosis was observed in six (7.7%) cases, and persistent hypothyroidism was diagnosed in 42 (53.8%) cases. In Group B, hyperthyroidism occurring during treatment with AM was found in 40 (33.9%) patients, and permanent hypothyroidism was observed in eleven (12.5%) cases. After annual follow-up in Group C, nine (11.4%) patients were diagnosed with hypothyroidism, while 27 (34.1%) patients were diagnosed with hyperthyroidism. In Group D, all patients had permanent hypothyroidism and when the concentration of serum thyroid-stimulating hormone was >10 µIU/mL, l-thyroxine was applied.ConclusionOur study showed that radioiodine administration is advisable in certain circumstances, even in euthyroid patients. It allows for continuation of further long-term AM treatment. Additionally, RIT allows for the reintroduction of AM therapy that was previously terminated. Hence, it can help control life-threatening tachyarrhythmias and decrease episodes of thyrotoxicosis.

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Section: Discussionmentioning

confidence: 99%

“…For this reason, after discontinuing the medication, its effect lingers for a considerable period of time. 6 …”

Section: Introductionmentioning

confidence: 99%

Dysfunction of the thyroid gland during amiodarone therapy: a study of 297 cases

Czarnywojtek

Płazińska

Zgorzalewicz-Stachowiak³

et al. 2016

TCRM

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“…As for oral amiodarone, the transfer ratios of organs such as the heart, liver, and lungs vary considerably in individuals. Oral amiodarone also shows the highest accumulation in adipose tissue because of its fat solubility [9]. On the basis of these reports, it is not entirely clear whether the blood concentration of amiodarone reflects the antiarrhythmic effect.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal analysis of the depressive effects of intravenous amiodarone on depolarization and repolarization: A case report

Yoshioka

Amino

Matsuzaki

et al. 2009

Journal of Cardiology

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Intravenous amiodarone (AMD) induces multiple antiarrhythmic effects via blocking of Na(+), Ca(2+), and IKr channels, and beta receptors. A patient on chronic dialysis was administered AMD for nonsustained ventricular tachycardia after successful cardiopulmonary resuscitation. QT prolongation occurred 5 h after AMD administration. AMD was withdrawn at 24 h because of prolonged QTc interval (716 ms), which persisted for a further 48 h (661 ms). Ventricular premature contraction (VPC) was significantly decreased at 7h; however, VPC increased again after discontinuing AMD. Depolarization changes induced by the Na(+)-channel blocking action of AMD were analyzed. There was increasing filtered QRS-duration and duration of low-amplitude signals at voltage <40 µV, and decreasing root-mean-square voltage of signals in the last 40 ms of ventricular late potentials (LPs) within 7 h. However after stopping AMD, LPs were reversed. The blood concentration of AMD reached the effective level within 10 min but decreased immediately to an ineffective level. Onset and disappearance of the VPC-inhibiting effect corresponded to the depressive effect on depolarization but not with the increase in the prolonged repolarization effect and blood concentration. Even if the QT interval is sufficiently prolonged, the Na(+)-channel blocking action is required for AMD to induce the antiarrhythmic effect.

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“…It is intriguing to speculate that electrophysiologic events amenable to pharmacologic manipulation may also be involved in the process of PBPC mobilization. Preferential retention of amiodarone in the marrow 37 and cytotoxic effects 38 could also contribute to its inhibitory influence on PBPC mobilization.…”

Section: Discussionmentioning

confidence: 99%

Rapid succession of peripheral blood progenitor cell mobilization cycles in patients with chronic heart failure: effects on the hematopoietic system

Hüttmann¹,

Gutersohn²,

Noppeney³

et al. 2006

Transfusion

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Amiodarone distribution in human tissues after long-term therapy: a case of arrhythmogenic right ventricular cardiomyopathy

Cited by 7 publications

References 10 publications

Dysfunction of the thyroid gland during amiodarone therapy: a study of 297 cases

Dysfunction of the thyroid gland during amiodarone therapy: a study of 297 cases

Longitudinal analysis of the depressive effects of intravenous amiodarone on depolarization and repolarization: A case report

Rapid succession of peripheral blood progenitor cell mobilization cycles in patients with chronic heart failure: effects on the hematopoietic system

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