Sotalol and a broken heart.
An 82-year-old woman with persistent atrial fibrillation underwent successful electrical cardioversion and was begun on sotalol. After 3 days of in-hospital observation she had only mild lengthening of the QT interval. Two weeks later in clinic, the day after her husband's unexpected death, she was noted to have profound QT interval prolongation. Although she was asymptomatic and echocardiography did not disclose regional wall motion abnormalities consistent with takotsubo cardiomyopathy, she probably had a forme fruste of stress cardiomyopathy. Following emotional trauma, a period of heightened vigilance for ventricular proarrhythmia is probably warranted in women treated with antiarrhythmic drugs that lengthen repolarization.
Friedman
Peter L
PL
Cape Cod Hospital, Hyannis, Massachusetts, USA. plfriedman@msn.com
Montgomery
Sarah
S
Matas
Nicholas
N
D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced* / Q000175:diagnosis; D013015:Sotalol / Q000009:adverse effects* / Q000627:therapeutic use*; D054549:Takotsubo Cardiomyopathy / Q000139:chemically induced* / Q000175:diagnosis
D000889:Anti-Arrhythmia Agents; D013015:Sotalol