Asystole during treatment with amiodarone in a patient with persistent atrial tachycardia.
During treatment with amiodarone, digoxin and nadolol, asystole occurred repeatedly in a patient with chronic persistent automatic atrial tachycardia. Asystole did not occur after discontinuation of drug therapy, and rechallenge with amiodarone alone produced marked overdrive suppression of all pacemakers resulting in asystole. Amiodarone serum level was within therapeutic range. The possible electrophysiologic mechanisms by which amiodarone might suppress both normal and abnormal pacemakers are discussed. The occurrence of asystole at therapeutic serum concentration of amiodarone suggests that this drug should be used with caution.
D000328:Adult; D000638:Amiodarone / Q000009:adverse effects* / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000139:chemically induced*; D001572:Benzofurans / Q000009:adverse effects*; D004077:Digoxin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced*; D006325:Heart Atria / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D009248:Nadolol; D011412:Propanolamines / Q000627:therapeutic use; D013610:Tachycardia / Q000188:drug therapy*
D000889:Anti-Arrhythmia Agents; D001572:Benzofurans; D011412:Propanolamines; D009248:Nadolol; D004077:Digoxin; D000638:Amiodarone