Suppression of amiodarone-induced torsade de pointes by landiolol in a patient with atrial fibrillation-mediated cardiomyopathy

Ann Noninvasive Electrocardiol. 2021 Nov;26(6):e12842. doi: 10.1111/anec.12842. Epub 2021 Mar 23.


An elderly Japanese woman developed acute decompensated heart failure caused by persistent atrial fibrillation (AF) and left ventricular systolic dysfunction. Approximately 6 days after starting intravenous administration of amiodarone (600 mg/day) for maintaining sinus rhythm after cardioversion of AF, electrocardiograms revealed a prolonged QT interval associated with torsade de pointes (TdP). The amiodarone-induced TdP disappeared after intravenous administration of landiolol plus magnesium and potassium, without discontinuation of amiodarone or overdrive cardiac pacing, although the prolonged QT interval persisted. To the best of our knowledge, this is the first report that landiolol could be effective for amiodarone-induced TdP.

Keywords: amiodarone; atrial fibrillation; heart failure; landiolol; long QT syndrome; torsade de pointes.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amiodarone* / adverse effects
  • Anti-Arrhythmia Agents / adverse effects
  • Atrial Fibrillation* / drug therapy
  • Cardiomyopathies*
  • Electrocardiography
  • Female
  • Humans
  • Morpholines
  • Torsades de Pointes* / chemically induced
  • Torsades de Pointes* / drug therapy
  • Urea / analogs & derivatives


  • Anti-Arrhythmia Agents
  • Morpholines
  • landiolol
  • Urea
  • Amiodarone