Publication:

Amiodarone causes QT prolongation in patients with atrial fibrillation complicating dyspepsia: a case report

A 62-year-old female patient presented to the hospital with complaints of dizziness, weakness, and fever for two days. On admission, her vital signs revealed an increased pulse rate and a temperature above normal. On the first day of hospitalization, her blood pressure rose to 145/94 mmHg before later fluctuating within the normal range. The patient's diagnosis included fatigue and febrile illness, dyspepsia, and AF RVR (Atrial fibrillation with rapid ventricular response). Subsequent laboratory tests showed elevated SGOT, SGPT, and CK-MB values above normal. Tests for HBSAg, anti-JAV, anti-HCV, and swab antigen were negative. During hospitalization, QT interval (QTc) prolongation was detected: the interval was 457 ms (Grade 1) on the second day and 481 ms (Grade 2) on the third day. Treatment began with Amiodarone 100 mg orally every 12 hours for the first two days. Additional medications included Bio Curliv (1 tablet every 8 hours orally), Zypraz (alprazolam) 0.25 mg once daily, tramadol 1 amp in 500 cc NaCl (infused over 8 hours as needed), Sistenol (N-acetylcysteine and paracetamol) 1 tablet every 8 hours orally, Norages (Metamizole) 1 ampoule on the first day, and Esomeprazole 1 tablet once daily. On the third day, Amiodarone was adjusted to 150 mg in 50 cc Dex 50% over 30 minutes, and then changed to 200 mg three times daily until discharge if the patient converted. Throughout treatment, pharmacists played an important role in monitoring for side effects, specifically QTc prolongation and elevated liver enzyme levels (SGOT and SGPT). Therefore, patients with AF require regular ECG monitoring to detect early QTc prolongation.