Acute Electrocardiographic Changes Coincident With Dofetilide Overdose and Acute Coronary Syndrome

David J King; Mudit Dutta; Ramil Goel; Kun Xiang

doi:10.1016/j.jaccas.2024.102709

Acute Electrocardiographic Changes Coincident With Dofetilide Overdose and Acute Coronary Syndrome

JACC Case Rep. 2024 Nov 20;29(22):102709. doi: 10.1016/j.jaccas.2024.102709.

Authors

David J King¹, Mudit Dutta¹, Ramil Goel², Kun Xiang³

Affiliations

¹ Department of Medicine, University of Florida, Gainesville, Florida, USA.
² VAMC and the University of Florida, Division of Cardiovascular Medicine, Gainesville, Florida, USA.
³ Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA.

Abstract

A 73-year-old man with atrial fibrillation and coronary disease requiring stenting to the right coronary artery 7 months prior was admitted for observation after taking an extra dofetilide dose. Troponins trended upward, and electrocardiogram demonstrated QT prolongation to 502 ms as well as T-wave inversions. The patient underwent cardiac catheterization, which revealed severe distal left main disease.

Keywords: IKR potassium channel; INa sodium channel; NSTEMI; QT prolongation; Tikosyn; acute coronary syndrome; dofetilide; non-ST-segment elevation myocardial infarction.