Collections Secondary QT Prolongation, Tor...

Secondary QT Prolongation, Torsades de Pointes and Risk of Sudden Death

An extensive review of drugs and medical conditions contributing to the risk of QT prolongation
Nauzer Forbes, Mohan Cooray, Raed Al-Dabbagh, Yuhong Yuan, Frances Tse, Louis W C Liu, Ted Xenodemetropoulos
Background. In 2012, Health Canada released a warning regarding domperidone use, based on associations with life-threatening arrhythmias and death. Objective. This study aimed to compare the appropriateness of domperidone prescribing patterns before the advisory to those afterward. Methods. Two retrospective reviews were conducted for patients prescribed domperidone during quarters in 2005 and 2012. Outcomes included appropriateness of indication, dosing regimens, monitoring of electrolytes, baseline electrocardiogram performance and characteristics, presence of left ventricular dysfunction, and coprescription of QT-prolonging medications...
2016: Canadian Journal of Gastroenterology & Hepatology
Tiziano Acciavatti, Giovanni Martinotti, Massimo di Giannantonio
No abstract text is available yet for this article.
May 2016: Journal of Clinical Psychiatry
Tessa Novick, Blaithin A McMahon, Adam Berliner, Bernard G Jaar
No abstract text is available yet for this article.
March 2016: European Journal of Clinical Pharmacology
Dan M Roden
Drugs used to treat cardiovascular disease as well as those used in the treatment of multiple other conditions can occasionally produce exaggerated prolongation of the QT interval on the electrocardiogram and the morphologically distinctive polymorphic ventricular tachycardia ('torsades de pointes'). This syndrome of drug-induced long QT syndrome has moved from an interesting academic exercise to become a key element in the development of any new drug entity. The prevailing view, which has driven both clinical care and drug regulation, holds that cardiac repolarization represents a balance between inward currents (primarily through calcium and sodium channels) and outward currents (primarily through rapid and slowed delayed rectifier potassium channels) and that block of the rapid delayed rectifier (IKr ) is the primary mechanism whereby drugs prolong individual action potentials, manifest on the surface electrocardiogram as QT interval prolongation...
May 1, 2016: Journal of Physiology
Nobuhiro Takasugi, Hiroko Goto, Mieko Takasugi, Richard L Verrier, Takashi Kuwahara, Tomoki Kubota, Hiroyuki Toyoshi, Takashi Nakashima, Masanori Kawasaki, Kazuhiko Nishigaki, Shinya Minatoguchi
BACKGROUND: Prevalence of microvolt T-wave alternans (TWA) and the strength of its association with torsade de pointes (TdP) history have not been fully investigated in patients with long QT syndrome (LQTS). METHODS AND RESULTS: Twenty-four-hour continuous 12-lead ECGs were recorded in 10 healthy subjects (5 men; median age, 21.5 years) and 32 patients (13 men; median age, 13 years) with LQTS types 1 (n=18), 2 (n=4), 3 (n=4), and unidentified (n=6). Peak TWA was determined by the Modified Moving Average method...
February 2016: Circulation. Arrhythmia and Electrophysiology
Andrew M Davis
No abstract text is available yet for this article.
February 2016: Circulation. Arrhythmia and Electrophysiology
Tal Lorberbaum, Kevin J Sampson, Raymond L Woosley, Robert S Kass, Nicholas P Tatonetti
INTRODUCTION: Drug-induced prolongation of the QT interval on the electrocardiogram (long QT syndrome, LQTS) can lead to a potentially fatal ventricular arrhythmia known as torsades de pointes (TdP). Over 40 drugs with both cardiac and non-cardiac indications are associated with increased risk of TdP, but drug-drug interactions contributing to LQTS (QT-DDIs) remain poorly characterized. Traditional methods for mining observational healthcare data are poorly equipped to detect QT-DDI signals due to low reporting numbers and lack of direct evidence for LQTS...
May 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Rachael A Lee, Allison Guyton, Danielle Kunz, Gary R Cutter, Craig J Hoesley
BACKGROUND: Azithromycin is used in the inpatient setting for a variety of conditions. In 2013, the US Food and Drug Administration released a warning regarding risk for corrected QT (QTc) prolongation and subsequent arrhythmias. Knowledge of inpatient prescribing patterns of QTc prolonging medications with respect to patient risk factors for adverse cardiovascular events can help recognize safe use in light of these new warnings. OBJECTIVE: To assess inpatient prescribing patterns, risk factors for QTc prolongation, and relationship between drug-drug interactions and cardiac monitoring in patients receiving azithromycin...
January 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Kevin J Friesen, Shawn C Bugden
BACKGROUND: Citalopram is the most commonly prescribed antidepressant in Canada. Concerns have been raised about its cardiac safety, and a dose-dependent prolongation of the QT interval has been documented. Drug interactions involving concomitant use of other medications that prolong the QT interval or increase citalopram levels by interfering with its metabolism increase the cardiac risk. Regulatory bodies (Health Canada and the US Food and Drug Administration) issued warnings and required labeling changes in 2011/2012, suggesting maximum citalopram doses (<40 mg for those <65 years; <20 mg for those ≥65 years) and avoiding drug interactions that increase cardiac risk...
2015: Drug, Healthcare and Patient Safety
Matthias Görges, Simon D Whyte, Shubhayan Sanatani, Joy Dawes, Carolyne J Montgomery, J Mark Ansermino
BACKGROUND: Clinical indications for the perioperative use of dexmedetomidine in pediatric anesthesia are accumulating. However, in 2013, dexmedetomidine was added to the list of medications with possible risk of prolonging the QT interval and/or inducing Torsades de Pointes. Unfortunately, current evidence for dexmedetomidine-induced QT prolongation is sparse and somewhat contradictory. OBJECTIVE: The purpose of this study was to evaluate temporal changes in corrected QT interval (QTc) after a rapid bolus administration of dexmedetomidine under total intravenous anesthesia (TIVA) with a standardized propofol and remifentanil administration...
December 2015: Paediatric Anaesthesia
Guillermo A Keller, Paulino A Alvarez, Marcelo L Ponte, Waldo H Belloso, Claudia Bagnes, Cecilia Sparanochia, Claudio D Gonzalez, M Cecilia Villa Etchegoyen, Roberto A Diez, Guillermo Di Girolamo
OBJECTIVE: The actual prevalence of drug induced QTc prolongation in clinical practice is unknown. Our objective was to determine the occurrence and characteristics of drug-induced QT prolongation in several common clinical practices. Additionally, a subgroup of patients treated with dextropropoxyphene of particular interest for the regulatory authority was analysed. RESEARCH DESIGN AND METHODS: Medical history and comorbidities predisposing to QT interval prolongation were registered for 1270 patient requiring medical assistance that involved drug administration...
2016: Current Drug Safety
Parin J Patel, Yuliya Borovskiy, Anthony Killian, Ralph J Verdino, Andrew E Epstein, David J Callans, Francis E Marchlinski, Rajat Deo
BACKGROUND: The QT interval measures cardiac repolarization, and prolongation is associated with adverse cardiovascular outcomes and death. The exponential Bazett correction formula overestimates the QT interval during tachycardia. OBJECTIVE: We evaluated 4 formulas of QT interval correction in individuals with sinus tachycardia for the identification of coronary artery disease, heart failure, and mortality. METHODS: The Penn Atrial Fibrillation Free study is a large cohort study of patients without atrial fibrillation...
February 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Françoise Van Bambeke
Oritavancin, telavancin, and dalbavancin are recently marketed lipoglycopeptides that exhibit remarkable differences to conventional molecules. While dalbavancin inhibits the late stages of peptidoglycan synthesis by mainly impairing transglycosylase activity, oritavancin and telavancin anchor in the bacterial membrane by the lipophilic side chain linked to their disaccharidic moiety, disrupting membrane integrity and causing bacteriolysis. Oritavancin keeps activity against vancomycin-resistant enterocococci, being a stronger inhibitor of transpeptidase than of transglycosylase activity...
December 2015: Drugs
Jeng-Feng Lin, Shun-Yi Hsu, Semon Wu, Ming-Sheng Teng, Hsin-Hua Chou, Shih-Tsung Cheng, Tien-Yu Wu, Yu-Lin Ko
OBJECTIVES: Heart-rate corrected QT (QTc) interval predicts cardiovascular mortality or all-cause mortality in the general population. Little is known about the best cut-off value of QTc interval for predicting clinical events in patients with ST-elevation myocardial infarction (STEMI). METHODS: We enrolled 264 patients with STEMI who received measurement of QTc intervals at ER (QTc-ER), on day 2 (QTc-D2), and on day 3 (QTc-D3) of hospitalization. Clinical events, including all-cause death and readmission for heart failure, were followed for 2 years...
2015: International Journal of Medical Sciences
Paolo Fais, Elisa Vermiglio, Chiara Laposata, Robert Lockwood, Rossella Gottardo, Domenico De Leo
The phenomenon of sudden cardiac death is usually related to the worsening of existing heart conditions leading to ventricular arrhythmia (VA). One of the well-known triggers of SCD is drug-induced prolongation of the QT interval, such as that caused by Domperidone (D). Despite its risk to prolong the QT interval and associated narrow therapeutic index, D is available as an over-the-counter (OTC) drug in many countries such as Italy, Ireland, Netherlands, China, South Africa, Mexico, New Zealand and Chile to treat gastroesophageal reflux and functional dyspepsia...
September 2015: Forensic Science International
Karyn R Fabo, Ann Marie Nye, Jane P Gagliardi, Christopher R Dennis, Andrew J Muzyk
OBJECTIVE: The US Food and Drug Administration (FDA) issued a warning stating that patients older than 60 years are not recommended to receive doses of citalopram exceeding 20 mg daily due to concerns of corrected QT (QTc) prolongation. The purpose of this study is to assess the impact of the FDA warning on prescribing patterns of citalopram in patients 60 years of age and older. METHOD: This is a retrospective cohort study of hospitalized patients 60 years of age and older prescribed citalopram from October 24, 2010, to August 24, 2011 and from November 24, 2011, to September 24, 2012...
2015: Primary Care Companion to CNS Disorders
Somayeh Khalesi, Hassan Shemirani, Faezeh Dehghani-Tafti
BACKGROUND: Methadone is a synthetic opioid, which has been successfully used in treating heroin addiction and chronic pain syndrome in palliative care for more than 30 years. This drug is a potent blocker of the delayed rectifier potassium ion channel, which may result in corrected QT (QTc) interval prolongation and increased risk of torsades de pointes (TdP) in susceptible individuals. CASE REPORT: We describe here a case of methadone-induced TdP that deteriorated into ventricular fibrillation, which was resolved after treatment with IV magnesium, potassium, and Lidocaine...
November 2014: ARYA Atherosclerosis
Martin Huemer, Giselle Sarganas, Elisabeth Bronder, Andreas Klimpel, Edeltraut Garbe, Wilhelm Haverkamp
Dronedarone is a promising, relatively new antiarrhythmic agent characterized by structural similarities to amiodarone but without amiodarone's severe organ toxicity. The proarrhythmic potential of dronedarone, however, is of increasing concern. We describe a 76-year-old woman who had been receiving dronedarone 400 mg twice/day to prevent recurrent atrial tachycardia with rapid ventricular response. Several months later, she came to the emergency department with decompensated congestive heart failure and episodes of atrial tachycardia; digoxin 0...
May 2015: Pharmacotherapy
Mohsin Chowdhury, Jason Wong, Angela Cheng, Michael Khilkin, Eugen Palma
AIMS: Methadone has been associated with QTc prolongation and ventricular arrhythmias but the prevalence of QTc prolongation and association with ventricular arrhythmias remains unclear. We investigated this in our inner city urban community (Bronx, New York) that has a large number of patients on methadone. METHODS: Telemetry records, nursing documentation and electronic charts of 291 patients spanning856 encounters were evaluated. QT was manually measured from ECG utilizing standardized QT measurement guidelines and was corrected for heart rate using Hodges formula...
June 2015: Cardiovascular Therapeutics
Mihailo Vukmirović, Irena Tomašević Vukmirović, Lazar Angelkov, Filip Vukmirović
INTRODUCTION: Long QT syndrome (LQTS) is a disorder of myocardial repolarization characterized by the prolongation of QT interval and high risk propensity of torsade de pointes (TdP) that can lead to syncope, cardiac arrest and sudden death. Episodes may be provoked by various stimuli depending on the type of the condition. CASE REPORT: A 25-year-old famele patient was hospitalized due to syncope that occurred immediately after her solo concert, first time in her life...
February 2015: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
2015-05-08 01:04:52
Fetch more papers »
Fetching more papers... Fetching...
Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.