Mesh : Acute Kidney Injury / etiology Aged, 80 and over Anti-Arrhythmia Agents / adverse effects therapeutic use Aortic Valve Insufficiency / drug therapy Bumetanide / adverse effects Cardiac Pacing, Artificial Dehydration / etiology Diuretics / adverse effects Electrocardiography Gastroenteritis / complications Heart Conduction System / drug effects Humans Kidney / drug effects Male Respiration, Artificial Sotalol / adverse effects therapeutic use Torsades de Pointes / chemically induced therapy

来  源:   DOI:10.2143/AC.64.6.2044756

Abstract:
We present a case of sotalol-induced prolongation of the QT-interval with torsades de pointes in an octogenarian who was hospitalized because of gastroenteritis causing prerenal acute renal failure. Subsequent accumulation of sotalol caused a severe prolongation of the QT-interval on the surface ECG and ultimately torsades de pointes with loss of consciousness. The patient was successfully treated with temporary cardiac pacing, intravenous magnesium sulfate and definitive withdrawal of sotalol. The electrophysiological basis of the pro-arrhythmic properties of sotalol is reviewed in brief, additional risk factors are identified and treatment is outlined.
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