Clinical Report: Refractory Ventricular Fibrillation Induced by Amiodarone

Overview

Revise to specify the role of moxifloxacin in the patient's condition and management.

Background

Septic cardiomyopathy (SCM) is a significant complication of sepsis, characterized by acute cardiac dysfunction and high mortality rates. The use of QT-prolonging medications, such as amiodarone, can lead to life-threatening arrhythmias, including torsades de pointes (TdP) and VF. Understanding the management of these arrhythmias in the context of SCM is crucial for improving patient outcomes.

Data Highlights

No numerical data or trial data presented in the article.

Key Findings

• An 89-year-old male developed septic cardiomyopathy and QTc prolongation after receiving moxifloxacin and amiodarone.
• He experienced refractory TdP and VF, unresponsive to standard resuscitative measures.
• Intravenous lidocaine combined with anisodamine successfully terminated the arrhythmias.
• Post-treatment, the patient's left ventricular function returned to baseline after 2 weeks.
• A 9-month follow-up indicated near-complete recovery of cardiac function.

Clinical Implications

This case underscores the importance of monitoring QTc intervals in patients receiving QT-prolonging agents, particularly in the context of septic cardiomyopathy. The combination of lidocaine and anisodamine may offer a viable treatment option for refractory arrhythmias in high-risk patients.

Conclusion

The management of refractory VF in patients with septic cardiomyopathy poses significant challenges. This case highlights the potential effectiveness of lidocaine and anisodamine in such scenarios, warranting further investigation.

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4. Frontiers in Pediatrics, Case Report: Nadolol–Mexiletine Combination Therapy for Refractory Neonatal Long QT Syndrome: A Case Series Beyond Sodium Channelopathies
5. Sepsis-Induced Cardiomyopathy: Mechanism, Prevalence, Assessment, Prognosis, and Management - ScienceDirect
6. 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
7. Comparison of the Effects of Lidocaine and Amiodarone on Patients With Cardiac Arrest: A Systematic Review and Meta-Analysis - PMC
8. Sepsis-Induced Cardiomyopathy: Mechanism, Prevalence, Assessment, Prognosis, and Management - ScienceDirect
9. 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care - Professional Heart Daily | American Heart Association
10. Comparison of the Effects of Lidocaine and Amiodarone on Patients With Cardiac Arrest: A Systematic Review and Meta-Analysis - PMC