amiodarone / Generic mfg. - LARVOL DELTA

Monitoring Serum Bisoprolol Concentrations in Patients With Heart Failure With Reduced Ejection Fraction: Results of a Pilot Study From Routine Health Care. (PubMed, Pharmacol Res Perspect) - "A significantly higher concentration-to-dose ratio and a significantly lower weight-adjusted apparent clearance were demonstrated in patients with reduced cardiac function, reduced renal function, and taking the combination with amiodarone. These patients may be more prone to overdose with bisoprolol."

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure

Pericardial Effusion Associated With Direct Oral Anticoagulant Use in a Single Center Experience. (PubMed, JACC Adv) - "This is the largest single center case series of DOAC PEff, with annual incidence higher than previously reported. Future research is needed to study the pharmacokinetic interactions between DOACs and commonly co-prescribed drugs as well as the cost-effectiveness of enhanced surveillance of PEff in those with solid cancer while on DOACs."

Journal • Cardiovascular • Oncology • Solid Tumor

Triplets in Tandem. (PubMed, J Electrocardiol) - "A few hours following cardioversion and amiodarone infusion, the monitor showed grouped beating in triplets and a 12‑lead electrocardiogram documented the same. What is the diagnosis?"

Journal • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Heart Failure • Ventricular Tachycardia

A Rare Case of Late Onset Familial Long QT Syndrome Presented with Recurrent Cardiac Arrest, Complete Heart Block, and NSTEMI. (PubMed, Acta Med Indones) - "She had a history of recurrent cardiac arrest due to ventricular arrhythmia and was treated with amiodarone continuous intravenous infusion in the previous hospital...Long QT Syndrome may occur at any period of life and may be asymptomatic. A thorough ECG examination before commencing treatment on a patient was pivotal to preventing malignant arrhythmia."

Journal • Cardiovascular • Myocardial Infarction • Pain • Ventricular Tachycardia

Amiodarone induced thyroiditis (ENDO 2025) - "He was initially diagnosed with suspected type 2 amiodarone induced thyroiditis and treated with a course of prednisone for 10 days...Atorvastatin and amiodarone were stopped at this time... Type 1 AIT is usually treated with thioamides, enhanced by potassium perchlorate to block iodine uptake, while type 2 AIT is best treated with oral glucocorticoids. Mixed forms may require a combination of these therapies. In refractory cases, thyroidectomy can be considered."

Atrial Fibrillation • Cardiomyopathy • Cardiovascular • Chronic Kidney Disease • Dyslipidemia • Endocrine Disorders • Fatigue • Hypertension • Musculoskeletal Pain • Myositis • Nephrology • Pain • Renal Disease

Unexpected New Onset of Grave's Disease in an 80 Year Old Female (ENDO 2025) - "She denied exposure to amiodarone, iodine, or recent viral illnesses...After 4 weeks, methimazole was reduced to 5 mg daily with normalization of her FT3 and FT4. Our case further illustrates the unexpected diagnosis of late-onset GD, given the patient's advanced age...The absence of classical symptoms and signs in older adults presents a diagnostic challenge and may lead to delay in treatment and poor outcome if not recognized.Ref: J Clin Endocrinol Metab, June 2010, 95(6):2715–2726*. .*"

Anorexia • Atrial Fibrillation • Cardiovascular • Cataract • Chronic Obstructive Pulmonary Disease • Congestive Heart Failure • Endocrine Disorders • Geriatric Disorders • Grave’s Disease • Heart Failure • Hypertension • Immunology • Infectious Disease • Movement Disorders • Ophthalmology • Osteoporosis • Pain • Respiratory Diseases • Rheumatology • Sarcopenia

Severe Hypothyroidism with Impending Myxedema Coma after Pembrolizumab Therapy (ENDO 2025) - "This is the case of a 72 y/o male with history of hypertension, atrial fibrillation on apixaban and amiodarone, chronic obstructive pulmonary disease GOLD 2A, hyperlipidemia, chronic kidney disease stage 2, seizures, oropharyngeal dysphagia, and stage IV lung squamous cell carcinoma with metastasis to the brain that failed to conventional therapy and was started on pembrolizumab 6 weeks ago...Patient was initially managed with IV bolus of hydrocortisone 100 mg and then started on IV levothyroxine (100 mcg once then 50 mcg daily) and Hydrocortisone IV drip for 3 days...Therefore, it is important to monitor thyroid function test closely in patients receiving these therapies for prompt recognition and treatment.*. .*"

Atrial Fibrillation • Cardiovascular • Chronic Kidney Disease • Chronic Obstructive Pulmonary Disease • CNS Disorders • Dyslipidemia • Endocrine Disorders • Epilepsy • Gastrointestinal Disorder • Heart Failure • Hypertension • Immunology • Nephrology • Non Small Cell Lung Cancer • Oncology • Otorhinolaryngology • Pulmonary Disease • Renal Disease • Respiratory Diseases

Iodine-Induced Thyrotoxicosis Leading to Severe Osteoporosis: A Case Report (ENDO 2025) - "Common sources include iodized salt, amiodarone, and seaweed-based supplements such as kelp. We report a case of iodine-induced thyrotoxicosis secondary to kelp consumption, resulting in severe osteoporosis, emphasizing the importance of dietary awareness in thyroid management.CaseA 58-year-old woman with osteoporosis, low BMI, and premature ovarian insufficiency (POI) was evaluated for worsening bone density despite prior treatment with alendronate...She was advised to avoid excessive iodine and was treated with prednisone. She also started denosumab but was lost to follow-up...Comprehensive care should include dietary counseling and, when needed, psychiatric evaluation to address behavioral patterns contributing to excessive supplement use and related health risks.*. .*"

Case report • Clinical • Cardiovascular • Endocrine Disorders • Movement Disorders • Musculoskeletal Diseases • Orthopedics • Osteoporosis • Psychiatry • Rheumatology • Women's Health

Navigating Metastatic Thyroid Cancer in the Context of Amiodarone Induced Iodine Overload (ENDO 2025) - "Post-thyroidectomy hypothyroidism was treated with levothyroxine (175 mcg/day), maintaining TSH <0.1 mIU/L due to metastatic disease.Diagnostic RAI imaging was contraindicated by iodine saturation...Discontinuing amiodarone and initiating dofetilide to facilitate iodine clearance.2...Key clinical lessons include:• Chronic amiodarone-induced iodine overload demands strategic tapering of amiodarone and the use of alternative antiarrhythmics.• Maintaining TSH suppression is critical to limiting tumor growth in metastatic PTC.• Close collaboration among endocrinology, cardiology, and oncology balances arrhythmia control and cancer management.• Tyrosine kinase inhibitors offer a viable bridge therapy when RAI is contraindicated or delayed.• Comorbidities, including the need for glycemic control and cardiovascular stability, underscore the importance of comprehensive, personalized care.*. .*"

Metastases • Atrial Fibrillation • Cardiovascular • Endocrine Cancer • Endocrine Disorders • Oncology • Solid Tumor • Thyroid Gland Carcinoma • Thyroid Gland Papillary Carcinoma • NKX2-1 • PAX8

Thyroid Function Testing Patterns in Newly Diagnosed Heart Failure (ENDO 2025) - "Main exclusions included receipt of amiodarone, dronedarone, lithium, anti-thyroid, or thyroid replacement medication within 1 year prior to hospitalization and lack of follow-up data through 90 days after discharge. Thyroid testing among patients with new-onset HF was inconsistent in a real-world setting. Testing was more prevalent among patients with HF with reduced ejection fraction, atrial fibrillation, and those receiving guideline directed medical therapy. In-hospital TSH testing resulted in changes in management for a small subset of patients, though the clinical validity and implications of this is uncertain.*."

Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Endocrine Disorders • Heart Failure

Challenging the Paradigm: IV Amiodarone in Thyroid Storm Without Worsening Thyrotoxicosis (ENDO 2025) - "He was started on IV esmolol and digoxin. Due to persistent tachycardia and hypotension precluding diltiazem use, an IV amiodarone drip was started as per cardiology recommendation...Hydrocortisone was tapered with the continual improvement of FT4, and methimazole was continued for new-onset hyperthyroidism, with outpatient follow-up planned for further workup.Conclusion This case highlights the potential use of IV amiodarone in thyroid storm for refractory arrhythmia despite maximal conventional management without worsening of thyrotoxicosis, as the patient's thyrotoxic symptoms and thyroid function improved despite IV amiodarone...However, data remain limited due to the absence of randomized controlled trials and their known thyrotoxic properties, for which further investigation is warranted.*. .*"

Ataxia • Atrial Fibrillation • Cardiovascular • Endocrine Disorders • Friedreich ataxia • Gastroenterology • Hepatology • Hypotension • Movement Disorders • Pulmonary Embolism • Respiratory Diseases • Septic Shock

Heart Ventricular Function In Hospitalized Patients With Severe Hypothyroidism (ENDO 2025) - "Exclusion criteria included ischemic coronary artery disease, cardiac arrest, implanted cardiac device, atrial fibrillation, amiodarone treatment, receiving hemodialysis, history of cardiotoxic chemotherapy, alcohol withdrawal, urgent surgery, or septic shock at admission... Severe hypothyroidism is associated with heart ventricular muscle dysfunction manifested by a high prevalence of patients (>70%) with increased GLS and, clinically, with low LVEF. *. .*"

Clinical • Atrial Fibrillation • Cardiovascular • Coronary Artery Disease • Endocrine Disorders • Septic Shock

Jod-Basedow Effect in a 76 Year Old With Atrial Fibrillation (ENDO 2025) - "Since then this patient has been managed with diltiazem for atrial fibrillation with RVR which has not been as effective. This patient was also not managed with any type of thyroid procedure because of the medication induced nature of their pathology.Labs: Potassium 3.3, sodium 140, creatine 1.05, white blood cell tan, hemoglobin 7.8, platelets 367, Magnesium 2.2, TSH 0.01 in a free T4 of 2.61Imaging: X-ray of the abdomen did also show up persistent of the left lung base and a inter tube with a bowel gas pattern. Patient had a Jod-Basedow effect in response to amiodarone which explains their hyperthyroid presentation*. .*"

Atrial Fibrillation • Cardiovascular • Endocrine Disorders

A Case of Ventricular Fibrillation Triggered by Thyroid Storm (ENDO 2025) - "The patient was started on methimazole and hydrocortisone to manage his thyroid storm. Amiodarone was briefly used to stabilize his cardiac rhythm...He also developed atrial fibrillation with rapid ventricular response, which was treated with propranolol...Taking all these factors into account, ventricular fibrillation due to thyroid storm in conjunction with low EF of heart appears to be the most probable cause of this out-of-hospital cardiac arrest.*. .*"

Clinical • Atrial Fibrillation • Cardiomyopathy • Cardiovascular • Coronary Artery Disease • Endocrine Disorders • Heart Failure • Hypertension • Myocardial Ischemia

Amiodarone-Induced Thyrotoxicosis: A race against time for a patient on the heart transplant list (ENDO 2025) - "Type 1 AIT is seen in patients with underlying thyroid gland disease and treated with methimazole or propylthiouracil...The combination of methimazole and prednisone at exceedingly high doses was successful yet slow in improving his state...The case also emphasizes the importance of monitoring thyroid function prior to and during amiodarone treatment.*. .*"

Clinical • Atrial Fibrillation • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Endocrine Disorders • Heart Failure • Immunology • Ophthalmology • Sarcoidosis • Transplantation • Ventricular Tachycardia • LMNA

The Storm That Wouldn't Subside: A Complex Case of Amiodarone-Induced Hyperthyroidism (ENDO 2025) - "Despite starting standard therapy for thyroid storm with betablockers, maximal thionamide and cholestyramine, there was no clinical improvement...It is important to not delay increases in prednisone dose if patients with suspected AIT2 do not improve on conventional doses, even if severe steroid-induced hyperglycemia may be a concern. Multimodal therapy is warranted when the patient is at high risk, their clinical course is complicated by a protracted treatment response, and/or when both AIT1 and AIT2 are suspected.*. .*"

Clinical • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Diabetes • Endocrine Disorders • Heart Failure • Metabolic Disorders

Scenario Changing and Efficacy of Therapeutic Plasma Exchange in the Treatment of Thyrotoxicosis (ENDO 2025) - "The main cause of thyrotoxicosis was Graves' disease (50.5%), followed by amiodarone-induced thyrotoxicosis (20.0%), iatrogenic thyrotoxicosis (7.6%), and others (12.4%)...TPE treatment of thyrotoxicosis has quite low mortality rate and incidence of adverse reactions, and deaths were mostly associated with TPE administered after thyroid storm, suggesting that earlier intervention with TPE may lead to better outcomes.*. .*"

Clinical • Endocrine Disorders • Grave’s Disease

Single Pass Albumin Dialysis for Refractory Amiodarone Induced Thyroid Storm (ENDO 2025) - "The patient was treated with maximal medical therapy including oral methimazole (120mg/day), intravenous hydrocortisone (300mg/day), Lugol's Iodine, and Cholestyramine. In our opinion, SPAD is a highly effective methodology and it should be utilized more frequently and earlier to reduce morbidity and mortality in thyroid storm.*. .*"

Cardiomyopathy • Cardiovascular • Chronic Kidney Disease • Coronary Artery Disease • Heart Failure • Hepatology • Liver Failure • Nephrology • Renal Disease • Ventricular Tachycardia

STELLATE GANGLION BLOCK FOR ELECTRICAL STORM IN A PATIENT WITH A BIVAD (ASRA-SPRING 2025) - "Numerous interventions were done during this period including multiple defibrillations (a total of 10, including sequential defibrillations), 4g of IV magnesium, paralysis with rocuronium, increased sedation on propofol and dexmedetomidine, weaning off norepinephrine and cross-titration to vasopressin and phenylephrine, amiodarone bolus followed by initiation of an infusion, lidocaine bolus followed by an increased infusion rate, and adjustment of RVAD flows...The patient's persistent ventricular arrythmia was persistent for approximately 49 minutes, at which time he underwent bilateral SGB under ultrasound guidance each with 10mL of 0.25% ropivacaine (Figure 3)...The proximity of this patient's bilateral SGB to cessation of ES suggests that this intervention was beneficial. SGB therefore appears to be safe and effective in treating ES in patients with BiVADs."

Clinical • Anesthesia • Cardiomyopathy • Cardiovascular • Dyslipidemia • Heart Failure • Hypertension • Infectious Disease • Pneumonia • Respiratory Diseases

STELLATE GANGLION BLOCKADE FOR REFRACTORY VENTRICULAR ELECTRICAL STORM IN A SEDATED AND ANTICOAGULATED PATIENT (ASRA-SPRING 2025) - "•A multidisciplinary team initiated VA ECMO, optimized pacemaker settings, and started lidocaine and amiodarone infusions...•On day 4, bilateral SGBs were performed with 5cc of 0.5% Ropivacaine per side while the patient was intubated, sedated, and on a heparin drip...•Despite these considerations, published institutional protocols highlight the safety and efficacy of providing SGB in high-risk patients during a critical window to transition to definitive therapies. •Further research is warranted to establish consensus guidelines and broaden the evidence base for this promising intervention."

Clinical • Anesthesia • Cardiovascular • Congestive Heart Failure • Heart Failure • Hematological Disorders • Hypertension • Inflammation • Ventricular Tachycardia

MULTI-TARGET PHRENIC NERVE SPARING TECHNIQUE AS PRIMARY ANESTHETIC FOR SHOULDER SURGERY IN PATIENT WITH CARDIOPULMONARY CONCERNS (ASRA-SPRING 2025) - "His past medical history was significant for hypertension, hyperlipidemia, smoking, obesity, chronic atrial fibrillation on rivaroxaban, amiodarone, and diltiazem, heart failure with ejection fraction 35-40%, sub- massive pulmonary embolism status post catheter assisted thrombolysis, and alcohol abuse with recent hospitalization for withdrawal, complicated by aspiration pneumonia requiring intubation...Due to low volume of the interscalene block, a supplemental anterior suprascapular block with 6 cc of 0.5% ropivacaine was added...The patient was sedated with propofol and dexmedetomidine infusions...This approach shows promise for future patients presenting for shoulder surgery with cardio-pulmonary comorbidities and needing avoidance of general anesthesia. Further decreasing the volume used for interscalene block would be recommended, to lessen the potential phrenic nerve involvement."

Clinical • Surgery • Anesthesia • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Dyslipidemia • Genetic Disorders • Heart Failure • Hypertension • Infectious Disease • Obesity • Pain • Pneumonia • Pulmonary Embolism • Respiratory Diseases

MANAGEMENT OF RAPID ATRIAL FIBRILLATION USING STELLATE GANGLION BLOCKADE (ASRA-SPRING 2025) - "She had predominantly been in NSR and was in NSR at her most recent regular follow-up visit while on metoprolol and apixaban...Digoxin and resumed sedation returned her to NSR...Given slowly rising white blood cell count to 13.5 g/dL, the ropivacaine infusion catheter was removed on hospital day 7. Pulsed-field ablation was performed on hospital day 11, and she was ultimately discharged on amiodarone to a subacute rehabilitation facility in normal sinus rhythm...Atrial fibrillation has been previously prevented with SGB in post-cardiac surgery patients.[3] This case report demonstrates a broadened scope for SGB for non-surgical patients. For this patient, the SGB and catheter were a vital bridge therapy to stabilize her before definitive treatment."

Anesthesia • Atrial Fibrillation • Cardiovascular • Cough • Metabolic Disorders • Pulmonary Disease • Respiratory Diseases • Thrombosis • Ventricular Tachycardia

SUCCESSFUL USE OF A STELLATE GANGLION CATHETER FOR SUPPRESSION OF REFRACTORY VT STORM (ASRA-SPRING 2025) - "VT was refractory to VT ablation, three cardioversions, and infusions and boluses of amiodarone, procainamide, and lidocaine...After negative aspiration, a bupivacaine-epinephrine mixture was injected under US visualization around the SG to confirm appropriate spread below the carotid artery and above the longus colli muscle and then a nerve catheter was threaded (see Image 2) and programmed for intermittent hourly boluses. Results Following SGC placement and ensuing hourly intermittent boluses of ropivacaine as well as continuation of his sedation, intubation, and anti-arrhythmic medical therapies, no further VT episodes occurred in the following seven days which bridged the patient to a successful heart transplant...A stellate ganglion catheter offers an extended duration of sympathetic outflow attenuation versus a stellate ganglion block. Goals for therapy and time until definitive management of VT storm should be considered to limit additional risk of repeating SGBs."

Anesthesia • Cardiomyopathy • Cardiovascular • Ventricular Tachycardia

Unique Treatment of Atrial Fibrillation: Simultaneous Dual Direct-Current Cardioversion in Morbidly Obese Patients. (PubMed, Cureus) - "The patient was treated with increasing doses of metoprolol without effective control of his AFib and had previously received amiodarone as well without appropriate response. Nasal continuous positive airway pressure and the use of dexmedetomidine supported airway patency and maintained spontaneous respirations while ensuring adequate depth of anesthesia. Morbidly obese patients likely require increased energy for cardioversion; thus, we describe the effectiveness of using simultaneous dual DCCV with two sets of pads in this patient after an unsuccessful single biphasic shock with 200 J."

Journal • Anesthesia • Atrial Fibrillation • Cardiovascular • Genetic Disorders • Infectious Disease • Obesity • Septic Shock

Amiodarone Should Be the First-Line Antiarrhythmic Treatment for Pulseless Ventricular Tachycardia and Ventricular Fibrillation. (PubMed, Ann Emerg Med) - No abstract available

Journal • Cardiovascular • Ventricular Tachycardia