J Rheum Dis.  2011 Dec;18(4):302-305. 10.4078/jrd.2011.18.4.302.

A Case of Atrial Fibrillation Induced by Infliximab in a Patient with Rheumatoid Arthritis

• Choi JW
• Tae HJ
• Oh IH
• Lee MK
• Shin JH
• Kim TH
• Jun JB
• Uhm WS

• KMID: 2223135
• DOI: http://doi.org/10.4078/jrd.2011.18.4.302

Abstract

Infliximab, a chimeric monoclonal immunoglobulin antibody to tumor necrosis factor (TNF)-alpha is widely used in the treatment of rheumatoid arthritis (RA). The commonly reported cardiac side effects of infliximab include exacerbation of congestive heart failure, hypotension, and syncope. Cardiac arrhythmia and conduction disturbances have been reported only rarely in a few case reports and to the best of our knowledge, there are no previous reports on the occurrence of atrial fibrillation secondary to infliximab use in RA patients. Here, we report a case of acute atrial fibrillation with rapid ventricular response that occurred 24 hr after first dose of infliximab in a 55-year-old female patient with RA, who recovered to sinus rhythm after pharmacologic management.

Keyword

Infliximab; Atrial fibrillation; Rheumatoid arthritis

MeSH Terms

Antibodies, Monoclonal
Arrhythmias, Cardiac
Arthritis, Rheumatoid
Atrial Fibrillation
Female
Heart Failure
Humans
Hypotension
Immunoglobulins
Middle Aged
Syncope
Tumor Necrosis Factor-alpha
Infliximab
Antibodies, Monoclonal
Immunoglobulins
Tumor Necrosis Factor-alpha

Figure

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  Figure 1. ECG, 12-lead electrocardiogram and rhythm strip showing atrial fibrillation with rapid ventricular response on presentation.

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  Figure 2. ECG, 12-lead electrocardiogram and rhythm strip after atrial fibrillation with rapid ventricular response reverted back to normal sinus rhythm following treatment with amiodarone.

Reference

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