Unintentional although providential iodinated contrast

An 88-year-old man was referred to our Unit for a bowel obstruction. The past history included a diagnosis of chronic obstructive pulmonary disease (COPD) with cor pulmonale treated with anti-cholinergic and glucocorticoid inhalation therapy, as well as prostate cancer. At admission he was periodically drowsy and confused. Arterial gas analysis demonstrated a mild respiratory failure with hypercapnia and normal arterial O2-saturation. The EKG showed a sinus rhythm. A few hours later atrial fibrillation began, and the patient was treated with an intravenous infusion of amiodarone, with recovery of a sinus rhythm. An amiodarone oral maintenance regimen was then started.