Division of Cardiovascular Medicine, AOI Universal Hospital, Kanagawa, Japan.
Ann Noninvasive Electrocardiol. 2021 May;26(3):e12810. doi: 10.1111/anec.12810. Epub 2020 Oct 18.
We report a 77-year-old human on renal dialysis for end-stage renal disease with heart failure and atrial fibrillation (AF) complicated by a high ventricular frequency. The underlying disease was thought as tachycardia-induced-cardiomyopathy. Intravenous infusion of amiodarone was initiated, and direct current cardioversion succeeded in converting AF to sinus rhythm. Then, excessive increases in the QT and Tpeak-Tend (Tp-e) intervals were seen and hypokalemia induced by hemodialysis led to the development of numerous episodes of torsades de pointes (TdP). Magnesium repletion was effective in preventing TdP, while Tp-e intervals returned to the previous values 2 days after the discontinuation of amiodarone.
我们报告一例 77 岁的血液透析患者，患有终末期肾病、心力衰竭和心房颤动（AF），伴有高频室性。基础疾病被认为是心动过速性心肌病。开始静脉输注胺碘酮，直流电复律成功将 AF 转为窦性节律。然后，观察到 QT 和 Tpeak-Tend（Tp-e）间期的过度延长，以及血液透析引起的低钾血症导致频发尖端扭转型室性心动过速（TdP）。镁补充有效预防了 TdP，而 Tp-e 间期在停用胺碘酮 2 天后恢复到之前的值。
