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Abstract
Infliximab, a chimeric monoclonal immunoglobulin antibody to tumor necrosis factor (TNF)-α is widely used in the treatment of rheumatoid arthritis (RA). The commonly reported cardiac side effects of infliximab include ex-acerbation 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.
References
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Figure 1.
ECG, 12-lead electrocardiogram and rhythm strip showing atrial fibrillation with rapid ventricular response on presentation.
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.
Table 1.
Case reports of arrhythmia after therapy with a tumor necrosis factor-α blocker or monoclonal anti-CD20 antibody
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