胺碘酮诱发新移植心脏QT间期延长并伴有反复室颤。

Amiodarone-induced QT prolongation in a newly transplanted heart associated with recurrent ventricular fibrillation.

作者信息

Schwarz E R, Czer L S, Simsir S A, Kass R M, Trento A

机构信息

Cedars Sinai Heart Institute, Division of Cardiology, Division of Cardiothoracic Surgery, Comprehensive Transplant Center, Cedars Sinai Medical Center, Los Angeles, and University of California Los Angeles, (UCLA), Los Angeles, USA.

出版信息

Cardiovasc J Afr. 2010 Mar-Apr;21(2):109-12.

PMID:20532436

Abstract

Anti-arrhythmic drugs such as amiodarone have the potential to prolong QT intervals, which can result in torsades de point arrhythmia. It is unknown whether amiodarone, given to a recipient prior to cardiac transplantation, can cause arrhythmia in a newly transplanted donor heart. We report on a case of a 71-year-old male patient who had received intravenous and oral amiodarone prior to transplantation, which was associated with QT prolongation in the transplanted heart after re-exposure to the drug during subsequent episodes of ventricular fibrillation. An ICD was implanted, which has not been described that soon after cardiac transplantation. Amiodarone, given to a recipient, might cause QT prolongation in a donor heart after transplantation, possibly due to its long half-life and increased bioavailability caused by interaction with immunosuppressive drugs.

摘要

胺碘酮等抗心律失常药物有可能延长QT间期，这可能导致尖端扭转型室性心律失常。在心脏移植前给予受者胺碘酮是否会在新移植的供体心脏中引起心律失常尚不清楚。我们报告了一例71岁男性患者，该患者在移植前接受了静脉和口服胺碘酮治疗，在随后的室颤发作期间再次接触该药物后，移植心脏出现QT延长。植入了植入式心脏复律除颤器（ICD），在心脏移植后这么快就植入ICD的情况此前未见报道。给予受者的胺碘酮可能会在移植后的供体心脏中导致QT延长，这可能是由于其半衰期长以及与免疫抑制药物相互作用导致生物利用度增加所致。