Atrial fibrillation following methylprednisolone pulse therapy

Abstract

Two children, one with renal manifestations of systemic lupus erythematosus and the other with idiopathic nephrotic syndrome, were treated with methylprednisolone pulses. Neither had previous evidence of underlying cardiac disease. Within 24 h of pulse therapy, they complained of palpitations and developed atrial fibrillation which reversed spontaneously or after anti-arrhythmic therapy. Subsequent serial electro- and echocardiograms were normal. We propose that the arrhythmias were a complication of steroid pulse therapy.

Atrial fibrillation and inflammation

“…The first observation of the possible relationship between corticosteroids and AF rates came from the study of Ueda et al [56] .…”

Czy stosowanie dużych dawek metyloprednizolonu w dożylnych pulsach u chorych z orbitopatią Gravesa jest bezpieczne?

“…U chorych leczonych i.v. GCS stwierdzano: migotanie przedsionków [23][24][25][26], trzepotanie przedsionków [27] , rytm węzłowy [28], częstoskurcz komorowy [29] i nadkomorowy [20], bradykardię [30][31][32], nagłe zatrzymanie krążenia [28,33,34], nagły zgon sercowy [20,35,36]. Należy zwrócić uwagę, że zagrażające życiu zaburzenia rytmu serca częściej były obserwowane u chorych palących papierosy, otyłych bądź u pacjentów z rozpoznaną wcześniej chorobą serca [18].…”

“…GCS therapy. Among them we can distinguish: atrial fibrillation [23][24][25][26], atrial flutter [27], junctional rhythm [28], ventricular tachycardia [29], supraventricular tachycardia [20], severe bradycardia [30][31][32]), asystole [28], cardiovascular collapse [33,34], and sudden death [20,35,36]. The incidence of significant, life-threatening cardiac arrhythmias after i.v.…”

Atrial Fibrillation in Children

“…Prescribed medication use may be associated with atrial fibrillation in children without structural heart disease. The use of corticosteroids, taken orally and inhaled, has been linked to atrial fibrillation in children (Huerta et al, 2005;Oteri et al, 2010;Ueda et al, 1988;Yamamura et al, 2011). There is one report of a child with hyperthyroidism presenting with atrial fibrillation (Perry & Hung, 1971).…”