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    4179 results match your criteria Torsade de Pointes

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    Acquired prolongation of QT interval as a risk factor for torsade de pointes ventricular tachycardia: a narrative review for the anesthesiologist and intensivist.
    J Anesth 2017 Feb 22. Epub 2017 Feb 22.
    Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, 21000, Serbia.
    More than 70% of intensive care unit (ICU) patients experience heart rhythm disturbances, and these patients have correspondingly higher mortality rates. Consequently, one of the standards of care in ICUs is continuous electrocardiography monitoring. One of the potentially preventable dysrhythmic events is the occurrence of torsade de pointes ventricular tachycardia in the setting of acquired prolonged QT interval. Read More

    Pharmacologic Conversion During Dofetilide Treatment for Persistent Atrial Fibrillation.
    Pacing Clin Electrophysiol 2017 Feb 21. Epub 2017 Feb 21.
    University of Rochester School of Medicine & Dentistry, Rochester, NY.
    Background: Dofetilide is a pure IKr blocker and is one of the few drugs specifically studied and approved in the United States for the management of persistent AF. Dofetilide has been noted to have a high rate of pharmacologic conversion during initial dosing in prior smaller studies. The intent of the study was to examine the safety of an inpatient loading strategy, and the incidence and patterns of pharmacologic conversion by dofetilide during the treatment of persistent AF in a large consecutive cohort. Read More

    A Common Genetic Variant Risk Score is Associated with Drug-Induced QT Prolongation and Torsade de Pointes Risk: A Pilot Study.
    Circulation 2017 Feb 17. Epub 2017 Feb 17.
    Center for Human Genetics and Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA & Broad Institute of Harvard and MIT, Cambridge, MA
    Background -Drug-induced QT interval prolongation, a risk factor for life-threatening ventricular arrhythmias, is a potential side effect of many marketed and withdrawn medications. The contribution of common genetic variants previously associated with baseline QT interval to drug-induced QT prolongation and arrhythmias is not known. Methods -We tested the hypothesis that a weighted combination of common genetic variants contributing to QT interval at baseline, identified through genome-wide association studies, can predict individual response to multiple QT-prolonging drugs. Read More

    Electrophysiological measurements that can explain and guide temporary accelerated pacing to avert (re)occurrence of Torsade de Pointes arrhythmias in the canine chronic atrioventricular block model.
    Heart Rhythm 2017 Feb 14. Epub 2017 Feb 14.
    Department of Medical Physiology, Division of Heart and Lungs, University Medical Center Utrecht, Yalelaan 50 3584CM Utrecht, The Netherlands. Electronic address:
    Background: Pacing at higher rates is known to suppress Torsade de Pointes (TdP) arrhythmias. Nevertheless, exact application and mechanism need further clarification. In the anesthetized, canine, chronic atrioventricular block model, ventricular remodeling is responsible for a high and reproducible incidence of TdP upon a challenge with dofetilide. Read More

    Improving the In Silico Assessment of Proarrhythmia Risk by Combining hERG (Human Ether-à-go-go-Related Gene) Channel-Drug Binding Kinetics and Multichannel Pharmacology.
    Circ Arrhythm Electrophysiol 2017 Feb;10(2):e004628
    From the Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD.
    Background: The current proarrhythmia safety testing paradigm, although highly efficient in preventing new torsadogenic drugs from entering the market, has important limitations that can restrict the development and use of valuable new therapeutics. The CiPA (Comprehensive in vitro Proarrhythmia Assay) proposes to overcome these limitations by evaluating drug effects on multiple cardiac ion channels in vitro and using these data in a predictive in silico model of the adult human ventricular myocyte. A set of drugs with known clinical torsade de pointes risk was selected to develop and calibrate the in silico model. Read More

    Study of factors affecting the progression and termination of drug induced Torsade de pointes in two dimensional cardiac tissue.
    J Electrocardiol 2017 Feb 2. Epub 2017 Feb 2.
    Biomedical Engineering Group, Department of Applied Mechanics, Indian Institute of Technology Madras, Chennai, India. Electronic address:
    Introduction: To study the conditions leading to the initiation and termination of drug induced Torsade de pointes (TdP) along with QT prolongation.

    Methods: A 2D anisotropic transmural section of the ventricular myocardium is modeled using the TP06 equations and the cells are interconnected with gap junction conductances (GJC). The tissue is remodeled by reducing the repolarization reserve (by increasing calcium current (ICaL)) of all cells thus making them vulnerable to development of early after depolarizations (EADs). Read More

    MicroRNA-135a Regulates Sodium-Calcium Exchanger Gene Expression and Cardiac Electrical Activity.
    Heart Rhythm 2017 Feb 7. Epub 2017 Feb 7.
    Department of Pharmacology and Therapeutics, McGill University, Montreal, Canada; Department of Medicine, Montreal Heart Institute and Université de Montréal, Essen, Germany; Institute of Pharmacology, West German Heart and Vascular Center, Faculty of Medicine, University Duisburg-Essen, Essen, Germany. Electronic address:
    Background: Complete atrioventricular block (CAVB) causes arrhythmogenic remodeling and increases the risk of Torsades de Pointes (TdP) arrhythmias. MicroRNAs (miRNAs) are key regulators of gene-expression that contribute to cardiac remodeling.

    Objective: To assess miRNA changes after complete atrioventricular block (CAVB) and identify novel candidates potentially involved in arrhythmogenic cardiac remodeling. Read More

    Methadone and Corrected QT Prolongation in Pain and Palliative Care Patients: A Case-Control Study.
    J Palliat Med 2017 Feb 10. Epub 2017 Feb 10.
    1 Department of Pharmacy Practice, Wegmans School of Pharmacy, St. John Fisher College , Rochester, New York.
    Background: Methadone (ME) is commonly used in pain and palliative care (PPC) patients with refractory pain or intolerable opioid adverse effects (AEs). A unique ME AE is its corrected QT (QTc) interval prolongation risk, but most evidence exists in methadone maintenance therapy patients.

    Objective: Our goal was to identify QTc interval prolongation risk factors in PPC patients receiving ME and other medications known to prolong the QTc interval and develop a risk stratification tool. Read More

    Severe Proarrhythmic Potential of the Antiemetic Agents Ondansetron and Domperidone.
    Cardiovasc Toxicol 2017 Feb 9. Epub 2017 Feb 9.
    Division of Electrophysiology, Department of Cardiovascular Medicine, University of Münster, Münster, Germany.
    The potential of ondansetron and domperidone, both clinically established antiemetic agents, to increase the QT-interval has been described in several case reports. Therefore, the aim of the present study was to investigate whether these drugs may provoke polymorphic ventricular tachycardia in a sensitive experimental model of drug-induced proarrhythmia. In 10 female rabbits, ondansetron (1, 5 and 10 µM, n = 10) or domperidone (0. Read More

    CSAHi study: Detection of drug-induced ion channel/receptor responses, QT prolongation, and arrhythmia using multi-electrode arrays in combination with human induced pluripotent stem cell-derived cardiomyocytes.
    J Pharmacol Toxicol Methods 2017 Feb 2. Epub 2017 Feb 2.
    Non-Clinical Evaluation Expert Committee, Drug Evaluation Committee, Japan Pharmaceutical Manufacturers Association (JPMA), 2-3-11 Nihonbashi-Honcho, Chuo-ku, Tokyo 103-0023, Japan; Consortium for Safety Assessment using Human iPS Cells (CSAHi), Japan(1); Biopharmaceutical Assessment Core Function Unit, Medicine Development Center, Eisai Co., Ltd., 5-1-3 Tokodai, Tsukuba, Ibaraki 300-2635, Japan.
    Introduction: The use of multi-electrode arrays (MEA) in combination with human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) provides a promising method to predict comprehensive cardiotoxicity, including drug-induced QT prolongation and arrhythmia. We previously demonstrated that MEA in combination with hiPSC-CMs could provide a generalizable platform by using 7 reference drugs at 10 testing facilities. Using this approach, we evaluated responses to reference drugs that modulate a range of cardiac ion currents and have a range of arrhythmogenic effects. Read More

    Delayed normalization of electrocardiograms in patients with takotsubo cardiomyopathy due to aneurysmal subarachnoid hemorrhage.
    World Neurosurg 2017 Jan 27. Epub 2017 Jan 27.
    Department of Cardiology, Miyazaki Medical Association Hospital, 738-1 Funato, Shinbeppu-cho, Miyazaki, Miyazaki 880-0834, Japan.
    Background: Takotsubo cardiomyopathy (TCM) is caused by excessive physical and mental stress, and sometimes causes potentially fatal arrhythmias such as torsades de pointes. This study characterized the features of TCM due to aneurysmal subarachnoid hemorrhage (SAH), particularly the delayed normalization of electrocardiograms compared to that of transthoracic echocardiograms.

    Methods: Ten patients with TCM were selected from the 450 SAH patients treated in our hospital between January 2007 and November 2015. Read More

    An 18-Year-Old Woman Who Was Found Down.
    Am J Cardiol 2017 Jan 6. Epub 2017 Jan 6.
    Section of Cardiology, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana. Electronic address:
    An 18-year-old woman was found unresponsive by her mother. After the patient spontaneously regained consciousness, an electrocardiogram showed a markedly prolonged QT interval thought to be due to congenital long QT1. An implantable cardioverter defibrillator was placed. Read More

    Recurrent takotsubo with prolonged QT and torsade de pointes and left ventricular thrombus.
    J Saudi Heart Assoc 2017 Jan 6;29(1):44-52. Epub 2016 Aug 6.
    Department of Cardiovascular Disease, International Medical Center, Jeddah, Saudi Arabia.
    Takotsubo cardiomyopathy, also known as "takotsubo syndrome," refers to transient apical ballooning syndrome, stress cardiomyopathy, or broken heart syndrome and is a recently recognized syndrome typically characterized by transient and reversible left ventricular dysfunction that develops in the setting of acute severe emotional or physical stress. Increased catecholamine levels have been proposed to play a central role in the pathogenesis of the disease, although the specific pathophysiology of this condition remains to be fully determined. At present, there have been very few reports of recurrent takotsubo cardiomyopathy. Read More

    Torsades de pointes with high-dose loperamide.
    J Electrocardiol 2017 Jan 16. Epub 2017 Jan 16.
    Department of Internal Medicine, Vanderbilt University Medical Center, 1161 21st Avenue South, D-3100 Medical Center North, Nashville, TN.
    Case: A 41year-old male presented with torsades de pointes. The patient was taking over 100mg of loperamide per day to self-medicate for chronic pain. Coronary angiography, cardiac magnetic resonance imaging, and genetic testing were negative for pre-disposing ischemia, cardiomyopathy, or genetic variant respectively. Read More

    The possible role of propofol in drug-induced torsades de pointes: A real-world single-center analysis.
    Int J Cardiol 2017 Apr 4;232:243-246. Epub 2017 Jan 4.
    Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ, United States.
    Background: Torsades de pointes (TdP) is a polymorphic ventricular tachycardia associated with QT prolongation. Propofol is a sedative-anesthetic with proarrhythmic effects on cardiac myocytes. We performed a retrospective study to determine the incidence of TdP following propofol exposure at Mayo Clinic (Rochester, MN) from 08/11/1998-11/20/2015. Read More

    Adverse event detection using the FDA post-marketing drug safety surveillance system: Cardiotoxicity associated with loperamide abuse and misuse.
    J Am Pharm Assoc (2003) 2017 Jan 7. Epub 2017 Jan 7.
    Objective: The purpose of this investigation was to identify and characterize post-marketing reports of cardiotoxicity, including torsades de pointes (TdP), associated with loperamide use.

    Methods: We searched the U.S. Read More

    Electrocardiographic Biomarkers for Detection of Drug-Induced Late Sodium Current Block.
    PLoS One 2016 30;11(12):e0163619. Epub 2016 Dec 30.
    Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, United States of America.
    Background: Drugs that prolong the heart rate corrected QT interval (QTc) on the electrocardiogram (ECG) by blocking the hERG potassium channel and also block inward currents (late sodium or L-type calcium) are not associated with torsade de pointes (e.g. ranolazine and verapamil). Read More

    Automated Algorithm for J-Tpeak and Tpeak-Tend Assessment of Drug-Induced Proarrhythmia Risk.
    PLoS One 2016 30;11(12):e0166925. Epub 2016 Dec 30.
    Office of Clinical Pharmacology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, United States of America.
    Background: Prolongation of the heart rate corrected QT (QTc) interval is a sensitive marker of torsade de pointes risk; however it is not specific as QTc prolonging drugs that block inward currents are often not associated with torsade. Recent work demonstrated that separate analysis of the heart rate corrected J-Tpeakc (J-Tpeakc) and Tpeak-Tend intervals can identify QTc prolonging drugs with inward current block and is being proposed as a part of a new cardiac safety paradigm for new drugs (the "CiPA" initiative).

    Methods: In this work, we describe an automated measurement methodology for assessment of the J-Tpeakc and Tpeak-Tend intervals using the vector magnitude lead. Read More

    Is cardiovascular risk a concern when prescribing azithromycin?
    JAAPA 2017 Jan;30(1):11-13
    S. Scott Sutton is a professor in the Department of Clinical Pharmacy and Outcomes Sciences in the South Carolina College of Pharmacy at the University of South Carolina in Columbia, S.C. The author has disclosed no potential conflicts of interest, financial or otherwise.
    The FDA has updated azithromycin package labeling to include the risk of prolonged cardiac repolarization and QT prolongation, which increase the possibility of cardiac dysrhythmias and torsades de pointes, especially in older adults. The update was initiated by a study that found an increased risk of death in patients taking azithromycin compared with those taking amoxicillin. However, cardiovascular results of other azithromycin studies have demonstrated discordant results, and more research is needed. Read More

    A good excuse for skipping the test: electrical storm in a teenager.
    Oxf Med Case Reports 2016 Dec 1;2016(12):omw086. Epub 2016 Dec 1.
    Department of Cardiology, Centro Hospitalar do Porto.
    We describe the case of a teenager with a structurally normal heart that presented with torsades de pointes and cardiac arrest. He had a history of epilepsy in childhood, mild cognitive impairment and cognitive visual dysfunction. The baseline electrocardiogram had prominent J waves and a marked early repolarization pattern in all the leads, with normal QT interval. Read More

    Evidence for the hERG Liability of Antihistamines, Antipsychotics, and Anti-Infective Agents: A Systematic Literature Review From the ARITMO Project.
    J Clin Pharmacol 2016 Dec 26. Epub 2016 Dec 26.
    Drug Safety Research Unit, Southampton, United Kingdom.
    A systematic review was performed to categorize the hERG (human ether-a-go-go-related gene) liability of antihistamines, antipsychotics, and anti-infectives and to compare it with current clinical risk of torsade de pointes (TdP). Eligible studies were hERG assays reporting half-minimal inhibitory concentrations (IC50). A "hERG safety margin" was calculated from the IC50 divided by the peak human plasma concentration (free Cmax ). Read More

    Knowledge Gain of Pharmacy Students and Pharmacists Comparing Simulation Versus Traditional Learning Methodology.
    J Pediatr Pharmacol Ther 2016 Nov-Dec;21(6):476-485
    Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.
    OBJECTIVES: The purpose of this study was to evaluate the difference between education via written materials alone and written materials enhanced with hands-on simulation. METHODS: A simulation case, educational module, and assessment regarding torsades de pointes (TdP) in an adolescent patient were designed. The written educational module was given to all study participants. Read More

    Video-Assisted Thoracoscopic Left Cardiac Sympathetic Denervation in Patients with Hereditary Ventricular Arrhythmias.
    Pacing Clin Electrophysiol 2016 Dec 24. Epub 2016 Dec 24.
    Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Daegu, Republic of Korea.
    Background: Left cardiac sympathetic denervation (LCSD) has been underutilized in patients with hereditary ventricular arrhythmia syndromes such as congenital long QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT). The purpose of this study was to investigate the safety and efficacy of video-assisted thoracoscopic (VATS) LCSD in such patients.

    Methods: Fifteen patients (four men, 24. Read More

    Risk factors for QTc-prolongation: systematic review of the evidence.
    Int J Clin Pharm 2017 Feb 23;39(1):16-25. Epub 2016 Dec 23.
    Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Herestraat 49, O&N2, Box 521, 3000, Leuven, Belgium.
    Background QTc-interval prolongation has been associated with serious adverse events, such as Torsade de Pointes and sudden cardiac death. In the prevention of QTc-prolongation, special attention should go to high-risk patients. Aim of the review The aim of this review is to summarize and assess the evidence for different risk factors for QTc-prolongation (demographic factors, comorbidities, electrolytes, QTc-prolonging medication). Read More

    Hyperventilation assists proarrhythmia development during delayed repolarization in clofilium-treated, anaesthetized, mechanically ventilated rabbits.
    J Physiol Pharmacol 2016 Oct;67(5):731-737
    Second Department of Medicine and Cardiology Centre, Faculty of Medicine, University of Szeged, Szeged, Hungary.
    Hyperventilation reduces partial pressure of CO2 (PCO2) in the blood, which results in hypokalaemia. Hypokalaemia helps the development of the life-threatening torsades de pointes type ventricular arrhythmia (TdP) evoked by repolarization delaying drugs. This implies that hyperventilation may assist the development of proarrhythmic events. Read More

    Mechanisms of IhERG/IKr Modulation by α1-Adrenoceptors in HEK293 Cells and Cardiac Myocytes.
    Cell Physiol Biochem 2016 19;40(6):1261-1273. Epub 2016 Dec 19.
    Department of Physiology, Faculty of Pharmacy, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain.
    Background: The rapid delayed rectifier K+ current (IKr), carried by the hERG protein, is one of the main repolarising currents in the human heart and a reduction of this current increases the risk of ventricular fibrillation. α1-adrenoceptors (α1-AR) activation reduces IKr but, despite the clear relationship between an increase in the sympathetic tone and arrhythmias, the mechanisms underlying the α1-AR regulation of the hERG channel are controversial. Thus, we aimed to investigate the mechanisms by which α1-AR stimulation regulates IKr. Read More

    [Antiemetics and cardiac effects potentially linked to prolongation of the QT interval: Case/non-case analysis in the national pharmacovigilance database].
    Rev Epidemiol Sante Publique 2016 Dec 14. Epub 2016 Dec 14.
    Inserm, U1171, degenerative and vascular cognitive disorders, 59000 Lille, France; Centre régional de pharmacovigilance, CHU de Lille, faculté de médecine, 1, place de Verdun, 59000 Lille, France.
    Objectives: Observational retrospective studies have linked domperidone and prolonged QT interval, ventricular arrhythmias and risk of sudden death. Since then, antiemetic prescription was applied to other molecules (including metopimazine). The aim of this study was to evaluate the profile of adverse cardiac effects associated with QT prolongation for each antiemetic available in France. Read More

    Disproportionality analysis of buprenorphine transdermal system and cardiac arrhythmia using FDA and WHO postmarketing reporting system data.
    Postgrad Med 2017 Jan;129(1):62-68
    a Purdue Pharma L.P ., Stamford , CT , USA.
    Objective: Positive-controlled clinical studies have shown a dose dependent effect of buprenorphine transdermal system on QTc interval prolongation. This study provides assessment of the buprenorphine transdermal system and cardiac arrhythmia using US FDA and WHO postmarketing reporting databases.

    Methods: Disproportionality analysis of spontaneously reported adverse events to assess whether the reporting rate of cardiac arrhythmia events was disproportionately elevated relative to expected rates of reporting in both FDA and WHO databases. Read More

    A new paradigm for drug-induced torsadogenic risk assessment using human iPS cell-derived cardiomyocytes.
    J Pharmacol Toxicol Methods 2016 Dec 10;84:111-127. Epub 2016 Dec 10.
    Japan iPS Cardiac Safety Assessment (JiCSA), 1-18-1 Kamiyoga, Setagaya-ku, Tokyo 158-8501, Japan(2); Japanese Safety Pharmacology Society (JSPS), 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan(3); Division of Pharmacology, National Institute of Health Sciences (NIHS), 1-18-1 Kamiyoga, Setagaya-ku, Tokyo 158-8501, Japan.
    Introduction: Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) are anticipated to be a useful tool for conducting proarrhythmia risk assessments of drug candidates. However, a torsadogenic risk prediction paradigm using hiPSC-CMs has not yet been fully established.

    Methods: Extracellular field potentials (FPs) were recorded from hiPSC-CMs using the multi-electrode array (MEA) system. Read More

    Role of 18F-Fluorodeoxyglucose/Positron Emission Tomography Imaging to Demonstrate Resolution of Acute Myocarditis.
    Can J Cardiol 2017 Feb 20;33(2):293.e3-293.e5. Epub 2016 Aug 20.
    Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. Electronic address:
    A young woman experienced complete heart block, leading to Torsades de pointes. Cardiac 18F-fluorodeoxyglucose/positron emission tomography was used to confirm the resolution of her acute myocarditis and was critical to the decision-making process that prevented unnecessary pacemaker insertion. Read More

    Electrophysiological Characteristics of Human iPSC-Derived Cardiomyocytes for the Assessment of Drug-Induced Proarrhythmic Potential.
    PLoS One 2016 6;11(12):e0167348. Epub 2016 Dec 6.
    Japan iPS Cardiac Safety Assessment (JiCSA), Kamiyoga, Setagaya-ku, Tokyo, Japan.
    The aims of this study were to (1) characterize basic electrophysiological elements of human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) that correspond to clinical properties such as QT-RR relationship, (2) determine the applicability of QT correction and analysis methods, and (3) determine if and how these in-vitro parameters could be used in risk assessment for adverse drug-induced effects such as Torsades de pointes (TdP). Field potential recordings were obtained from commercially available hiPSC-CMs using multi-electrode array (MEA) platform with and without ion channel antagonists in the recording solution. Under control conditions, MEA-measured interspike interval and field potential duration (FPD) ranged widely from 1049 to 1635 ms and from 334 to 527 ms, respectively and provided positive linear regression coefficients similar to native QT-RR plots obtained from human electrocardiogram (ECG) analyses in the ongoing cardiovascular-based Framingham Heart Study. Read More

    Ventricular tachycardia and prolonged QT interval presenting as seizure-like activity: A case report.
    Am J Emerg Med 2016 Nov 22. Epub 2016 Nov 22.
    Division of Emergency Medicine, University of Washington, United States.
    Seizures can be difficult to distinguish from other causes of transient cerebral hypoxia in the emergency room. We present a case of seizure activity in a woman in whom EKG led to a diagnosis of intermittent monomorphic and polymorphic ventricular tachycardia (torsades de pointes), highlighting the need for careful consideration of alternative causes of seizures, even in patients with known epilepsy. Read More

    Selective serotonin reuptake inhibitors and cardiovascular events: A systematic review.
    J Res Med Sci 2016 1;21:66. Epub 2016 Sep 1.
    Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran; Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.
    Background: Given the importance of the role of depression in predicting the outcome of cardiovascular disorders, current medications for treating depression, particularly selective serotonin reuptake inhibitors (SSRIs), are taken into consideration. This study aimed to systematically review the published findings in the use of SSRIs and the risk for cardiac events.

    Materials And Methods: An independent review of the Web of Science, PubMed, Scopus, Cochrane, CINAHL, index Copernicus, and Google Scholar, up to 2014, was performed. Read More

    Investigating the Additive Interaction of QT-Prolonging Drugs in Older People Using Claims Data.
    Drug Saf 2017 Feb;40(2):133-144
    Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
    Introduction: Drugs that potentially prolong the QT interval carry the risk of life-threatening Torsades de pointes (TdP) ventricular arrhythmia.

    Objective: The objective of this study was to investigate the potential additive risk for ventricular arrhythmia with concomitant prescriptions of QT-prolonging drugs.

    Methods: Claims data for persons aged ≥65 years between 2010 and 2012 in Germany were analyzed and all cases hospitalized for ventricular arrhythmia were selected. Read More

    Reckless administration of QT interval-prolonging agents in elderly patients with drug-induced torsade de pointes.
    Z Gerontol Geriatr 2016 Nov 22. Epub 2016 Nov 22.
    Department of Internal Medicine and Geriatrics D, Sheba Medical Center, 5265601, Tel-Hashomer, Israel.
    A systematic review was conducted for all published case reports on drug-induced torsade de pointes (TdP) in elderly (≥80 years) patients to study if the administration of the offending agent was reckless. Overall, 61 reports on drug-induced TdP in patients aged 80-97 years were included in the analysis. Non-modifiable risk factors for drug-induced TdP (e. Read More

    Life threatening torsades de pointes due to abiraterone-induced hypokaelemia in a patient with metastatic prostate cancer.
    N Z Med J 2016 Nov 18;129(1445):124-127. Epub 2016 Nov 18.
    Consultant Cardiologist, Bay of Plenty District Health Board, Tauranga.
    We present a case of a 77 year-old gentleman with previous coronary artery bypass grafting, admitted to hospital with recurrent torsades de pointes (TdP) due to abiraterone-induced hypokalaemia and prolonged QTc. The patient was on abiraterone and prednisone for metastatic prostate cancer. He required multiple defibrillations for recurrent TdP. Read More

    Management of Patients with Long QT Syndrome.
    Korean Circ J 2016 Nov 20;46(6):747-752. Epub 2016 Oct 20.
    Department of Internal Medicine, Kyungpook National Univeristy Hospital, Daegu, Korea.
    Long QT syndrome (LQTS) is a rare cardiac channelopathy associated with syncope and sudden death due to torsades de pointes and ventricular fibrillation. Syncope and sudden death are frequently associated with physical and emotional stress. Management of patients with LQTS consists of life-style modification, β-blockers, left cardiac sympathetic denervation (LCSD), and implantable cardioverter-defibrillator (ICD) implantation. Read More

    Early assessment of proarrhythmic risk of drugs using the in vitro data and single-cell-based in silico models: proof of concept.
    Toxicol Mech Methods 2016 Nov 23:1-12. Epub 2016 Nov 23.
    a Simcyp Limited (a Certara Company), Blades Enterprise Centre , Sheffield , UK.
    Background And Purpose: To determine the predictive performance of in silico models using drug-specific preclinical cardiac electrophysiology data to investigate drug-induced arrhythmia risk (e.g. Torsade de pointes (TdP)) in virtual human subjects. Read More

    Ventricular fibrillation via torsade des pointes of cardiac sarcoidosis with preserved left ventricular ejection fraction.
    BMJ Case Rep 2016 Oct 25;2016. Epub 2016 Oct 25.
    Cardiovascular Center, Tazuke Kofukai Foundation, Medical Research Institute, Kitano Hospital, Osaka, Japan.
    Generally, low left ventricular ejection fraction (LVEF) is a risk for ventricular arrhythmia in patients with cardiac sarcoidosis. We present a case of cardiac sarcoidosis with preserved LVEF that evoked ventricular fibrillation (VF). A 73-year-old woman with VF presented to our emergency department. Read More

    Significance of integrated in silico transmural ventricular wedge preparation models of human non-failing and failing hearts for safety evaluation of drug candidates.
    J Pharmacol Toxicol Methods 2017 Jan - Feb;83:30-41. Epub 2016 Aug 18.
    Department of Cardiovascular Medicine, Heart Rhythm Center, Shiga University of Medical Science, Otsu, Japan.
    Introduction: To evaluate the usefulness of in silico assay in predicting drug-induced QTc prolongation and ventricular proarrhythmia, we describe in this study 2-dimensional transmural ventricular wedge preparation model (2D model) of non-failing (non-FH) and failing hearts (FH) based on O'Hara-Rudy dynamic model of human ventricular myocytes.

    Methods: Using the prepared 2D model, we simulated ventricular action potential and recorded electrocardiogram for the non-FH and FH. The FH model was constructed based on differences in mRNA, protein, and/or current levels of ion channels between non-diseased heart and failing heart. Read More

    Phenotypic Variability of ANK2 Mutations in Patients With Inherited Primary Arrhythmia Syndromes.
    Circ J 2016 Nov 25;80(12):2435-2442. Epub 2016 Oct 25.
    Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science.
    Background: Mutations inANK2have been reported to cause various arrhythmia phenotypes. The prevalence ofANK2mutation carriers in inherited primary arrhythmia syndrome (IPAS), however, remains unknown in Japanese. Using a next-generation sequencer, we aimed to identifyANK2mutations in our cohort of IPAS patients, in whom conventional Sanger sequencing failed to identify pathogenic mutations in major causative genes, and to assess the clinical characteristics ofANK2mutation carriers. Read More

    Influence of steroid hormones on ventricular repolarization.
    Pharmacol Ther 2016 Nov 22;167:38-47. Epub 2016 Jul 22.
    INSERM, CIC-1421 and UMR ICAN 1166, France; AP-HP, Pitié-Salpêtrière Hospital, Department of Pharmacology and CIC-1421, France; Sorbonne Universités, UPMC Univ Paris 06, Faculty of Medicine, France; Institute of Cardiometabolism and Nutrition (ICAN), F-75013 Paris, France. Electronic address:
    QT interval prolongation, corrected for heart rate (QTc), either spontaneous or drug-induced, is associated with an increased risk of torsades de pointes and sudden death. Women have longer QTc than men and are at higher risk of torsades de pointes, particularly during post-partum and the follicular phase. Men with peripheral hypogonadism have longer QTc than healthy controls. Read More

    Electrocardiographic Parameters Indicating Worse Evolution in Patients with Acquired Long QT Syndrome and Torsades de Pointes.
    Ann Noninvasive Electrocardiol 2016 Nov 28;21(6):572-579. Epub 2016 Mar 28.
    Division of Cardiology,  Kingston General Hospital, Queen's University, Kingston, Ontario, Canada.
    Background: Acquired long QT syndrome (a-LQTS) is associated with life-threatening ventricular arrhythmias, mainly torsades de pointes (TdP). ECG parameters predicting evolving into ventricular fibrillation (VF) are ill defined.

    Aims: To determine ECG parameters preceding and during TdP associated with higher risk of developing VF. Read More

    Treating arrhythmias with adjunctive magnesium: identifying future research directions.
    Eur Heart J Cardiovasc Pharmacother 2016 Sep 15. Epub 2016 Sep 15.
    Department of Pharmacy Practice, School of Pharmacy, University of Connecticut, 69 N. Eagleville Rd, Unit 3092, Storrs, CT 06268, USA
    Magnesium is the fourth most abundant cation in the human body and is the second most prevalent cation in intracellular tissues. Myocardial cell action potentials are mediated by voltage-dependent Na(+), K(+), and Ca(2+ )channels which, when their function is altered, can lead to the genesis of cardiac dysrythmias. Magnesium regulates the movement of ions through these channels within myocardial tissues. Read More

    Does Sotalol Still Have a Role in the Management of Arrhythmias?
    Am J Ther 2016 Oct 3. Epub 2016 Oct 3.
    1Gold Coast Hospital and Health Service, Southport, Queensland, Australia; 2School of Medicine, Griffith University, Gold Coast, Queensland, Australia; and 3School of Medical Science, Griffith University, Gold Coast, Queensland, Australia.
    Despite proven effectiveness in treating tachyarrhythmias, sotalol is proarrhythmic and can cause torsades de pointes. Given the emergence of studies that show no benefit from rhythm control strategies in managing atrial fibrillation, as well as the introduction of nonpharmacological approaches to treating arrhythmias, we felt it necessary to ascertain if there was any role for sotalol given its side effects. Review of the literature regarding sotalol use in the prevention and treatment of supraventricular and ventricular tachyarrhythmias seems to show that more effective and safer agents and nonpharmacological alternatives are currently available. Read More

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