Efficacy of Amiodarone in Tachycardia Induced Cardiomyopathy due to Non-Valvular Atrial Fibrillation

BACKGROUND AND OBJECTIVES: Drug therapy to treat atrial fibrillation has been achieved unsatisfactory results due to the frequent failure to maintain a sinus rhythm as well as the occurrence of adverse side effects. This study investigated the efficacy of amiodarone for the treatment of tachycardia-induced cardiomyopathy due to non-valvular atrial fibrillation. SUBJECTS AND METHODS: We treated twenty-seven patients with tachycardia-induced cardiomyopathy due to non-valvular atrial fibrillation with amiodarone in order to convert to and maintain the sinus rhythm. We followed up and compared the functional status, electrocardiography and parameters of echocardiography before and after treatment with amiodarone. RESULTS: Patients treated with amiodarone showed cardiac functional improvement based on New York Heart Association classification. Eighteen patients (66.7%) out of the total 27 converted to sinus rhythm. The pulse rate decreased from 109.0+/-34 bpm (beats per min) before the administration of amiodarone to 70.3+/-13.0 bpm after medication. The size of the left atrium decreased from 50.7+/-6.7 (mm) to 46.9+/-5.6 (mm). The ejection fraction (EF) improved from 36.2+/-14.9 (%) to 51.2+/-17.7 (%). CONCLUSION: Amiodarone is effective in the conversion to sinus rhythm as well as ventricular rate control in patients with atrial fibrillation induced cardiomyopathy. The cardiac functional status and the echocardiographic parameters of left ventricular function in patients with tachycardia-induced cardiomyopathy due to atrial fibrillation improved with amiodarone therapy.

A Case of Extrapulmonary Disseminated Tuberculosis Including Tuberculous Meningitis in combination with Acute Myelogenous Leukemia / 대한혈액학회지

The occurrence of disseminated tuberculosis in combination with acute leukemia is rare. A 28 year old male undergoing induction chemotherapy for AML presented with fever of unknown origin. Upon the studies to make the diagnosis this case turned out to be disseminated tuberculosis including meningitis. The chest CT showed multiple enlarged mediastinal lymphadenopathy. The Brain CT showed noncommunicating obstructive hydrocephalus. Disseminated tuberculosis was pathologically proven by theliver, bone marrow and mediastinal lymph node biopsies. As clinical course improved, radiological lesions were completely resolved after antituberculosis therapy. It is important to consider disseminated tuberculosis for the etiology of FUO inpatient with AML who had suffered from long standing fever.