Torsade de pointes during loading with amiodarone

Torsade de pointes represents a potential complication of chronicamiodarone therapy. Several reports have emphasized the needfor a loading dose in order to achieve therapeutic blood levelsrapidly. We report a case of torsade de pointes following asingle oral dose of amiodarone (1400 mg or 30 mg kg^–1)administered after short intravenous loading for preventionof paroxysmal atrial flutter. Torsades de pointes were precededand associated with marked QT prolongation and bradycardia.This report suggests that careful monitoring of patients undergoingoral amiodarone loading is necessary.