A Case of Dronedarone-Induced Hypotensive Shock.

Atrial fibrillation (AF) is the most common cardiac arrhythmia. Dronedarone is a new antiarrhythmic used for rhythm and rate control in AF and is associated with reduced mortality in non-permanent AF. It has also been associated with increased mortality in those with heart failure and/or permanent AF. This case report presents the case of hypotensive shock after initiating treatment with dronedarone in a 73-year-old female patient. Shortly after her first dose of dronedarone, she developed hypotension that did not respond to intravenous fluids and was admitted to the intensive care unit for vasopressor administration. Dronedarone was the most likely cause of the hypotension as the patient's blood pressure normalized in 24 hours, which concurs with the half-life of dronedarone. Amiodarone and dronedarone are similar in composition; however, the absence of iodine moieties in dronedarone contributes to its improved side-effect profile. Furthermore, amiodarone has been linked to hypotensive shock likely due to a co-solvent used in some intravenous preparations; however, dronedarone-induced hypotension is less common.