Voriconazole-Induced Junctional Tachycardia: A Case Report

Voriconazole-Induced Junctional Tachycardia: A Case Report

Introduction: The antifungal voriconazole is effective for the treatment of invasive fungal infections in immunocompromised patients. A serious adverse reaction to other triazoles is QT interval prolongation, which may precede life-threatening arrhythmias, such as twisted tips. Although ventricular...

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Bibliographic Details
Published in:Drug safety Vol. 45; no. 10; p. 1162
Main Authors: Bouaziz, I, Ksouda, K, Ksentini, M, Affes, H, Athyemen, R, Sahnoun, R, Hammami, S, Zghal, K
Format: Journal Article
Language:English
Published: Auckland Springer Nature B.V 01-10-2022
Subjects:
Acute lymphoblastic leukemia
Antifungal agents
Arrhythmia
Azoles
Candidiasis
Cardiac arrhythmia
Case reports
Fungicides
Heart rate
Hemoglobin
Heterocyclic compounds
Immunocompromised hosts
Infections
Invasiveness
Leukemia
Leukocytes
Leukocytes (neutrophilic)
Patients
Pharmacovigilance
Potassium
Prolongation
Tachycardia
Ventricle
Voriconazole
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Summary:Introduction: The antifungal voriconazole is effective for the treatment of invasive fungal infections in immunocompromised patients. A serious adverse reaction to other triazoles is QT interval prolongation, which may precede life-threatening arrhythmias, such as twisted tips. Although ventricular arrhythmias are mentioned as a possible adverse effect of treatment with voriconazole (1). Objective: We report a case report of Voriconazole-induced junctional tachycardia notified in the Regional Pharmacovigilance Service of Sfax. Methods: The imputability study was performed according to the French Begaud method. Results: A 15-year-old patient with acute lymphoblastic leukemia and candidiasis infection was treated with Voriconazole. He developed 15 days later junctional tachycardia. Laboratory examinations showed a white blood cell count of 8140/mm3, absolute neutrophil count of 300/mm3, hemoglobin level of 4.4 g/dL, platelet count of 54,000/mm3, sodium level of 133/mm3 and potassium level of 3.5/mm3. Voriconazole was continued and the patient was treated with Flecainide with slight improvement. The imputability score of voriconazole for junctional tachycardia was rated as doubtful C1S2I1B2 Conclusion: Voriconazole can induce QT prolongation and ventricular arrhythmia in the absence of other arrhythmogenic factors. It is recommended, as a precautionary measure, to monitor the heart rate and QT interval in patients receiving long-term treatment with voriconazole and, possibly, in patients receiving treatment with other antifungal azoles (1). The mechanism may be dependent or independent of dose and concentration
ISSN:0114-5916
1179-1942