Proarrhythmia in a Patient With Heart Failure on Therapy With Amiodarone

Abstract

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.

Total Testosterone as a Specific Marker of Acute Kidney Injury in Male Patients With Myocardial Infarction

“…CRP is primarily metabolized by the liver [25]. Venous renal and liver congestion in cases of low EF and elevated left ventricular filling pressures could also lead to impaired liver clearance [26] and raised plasma levels of CRP.…”

“…CRP is primarily metabolized by the liver [ 25 ]. Venous renal and liver congestion in cases of low EF and elevated left ventricular filling pressures could also lead to impaired liver clearance [ 26 ] and raised plasma levels of CRP. In an observational study, inflammatory biomarkers, including CRP, were elevated in participants with GFR<60 ml/min/1.73 m 2 vs. GFR≥60 ml/min/1.73 m 2 [ 27 ].…”