4,993 results match your criteria Torsade de Pointes

Long QT syndrome - Bench to bedside.

Heart Rhythm O2 2021 Feb 22;2(1):89-106. Epub 2021 Jan 22.

Department of Physiology and Cell Biology, The Ohio State University, Columbus, Ohio.

Long QT syndrome (LQTS) is a cardiovascular disorder characterized by an abnormality in cardiac repolarization leading to a prolonged QT interval and T-wave irregularities on the surface electrocardiogram. It is commonly associated with syncope, seizures, susceptibility to torsades de pointes, and risk for sudden death. LQTS is a rare genetic disorder and a major preventable cause of sudden cardiac death in the young. Read More

View Article and Full-Text PDF
February 2021

Extracorporeal treatment for poisoning to beta-adrenergic antagonists: systematic review and recommendations from the EXTRIP workgroup.

Crit Care 2021 Jun 10;25(1):201. Epub 2021 Jun 10.

Research Center, CIUSSS du Nord-de-L'île-de-Montréal, Hôpital du Sacré-Coeur de Montréal, University of Montreal, Montreal, QC, Canada.

Background: β-adrenergic antagonists (BAAs) are used to treat cardiovascular disease such as ischemic heart disease, congestive heart failure, dysrhythmias, and hypertension. Poisoning from BAAs can lead to severe morbidity and mortality. We aimed to determine the utility of extracorporeal treatments (ECTRs) in BAAs poisoning. Read More

View Article and Full-Text PDF

Loperamide Toxicity Revealing Apical Hypertrophic Cardiomyopathy.

Methodist Debakey Cardiovasc J 2021 Apr 25;17(1):65-67. Epub 2021 Mar 25.

Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas.

Loperamide, a μ-opioid receptor agonist, can cause cardiotoxicity by inhibiting the potassium ion channel and slowing cardiomyocyte repolarization. This, in turn, can lead to frequent early afterdepolarizations, the most common mechanism of drug-induced long QT syndrome and torsades de pointes. Apical hypertrophic cardiomyopathy (AHCM) is a nonobstructive hypertrophic cardiomyopathy rarely associated with malignant arrhythmias. Read More

View Article and Full-Text PDF

A tale of two extremities: A dynamic case of Covid-19 induced hypokalemia and bradycardia leading into Torsade's de pointes.

Ann Med Surg (Lond) 2021 Jun 27;66:102416. Epub 2021 May 27.

William Harvey Hospital, UK.

Introduction: As researchers and academics around the world scramble ahead to dissect and analyse every aspect of the SARS-CoV2 virus, one such study explored the various underlying electrolyte abnormalities that were precipitated in patients suffering from a confirmed COVID-19 infection. A significant proportion of such patients were noted to be hypokalemic. Hypokalemia can be life threatening as it is known to cause cardiac arrhythmia. Read More

View Article and Full-Text PDF

Effect of Hydroxychloroquine on QTc in Patients Diagnosed with COVID-19: A Systematic Review and Meta-Analysis.

J Cardiovasc Dev Dis 2021 May 13;8(5). Epub 2021 May 13.

Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA.

Background: Hydroxychloroquine or chloroquine with or without the concomitant use of azithromycin have been widely used to treat patients with SARS-CoV-2 infection, based on early in vitro studies, despite their potential to prolong the QTc interval of patients.

Objective: This is a systematic review and metanalysis designed to assess the effect of hydroxychloroquine with or without the addition of azithromycin on the QTc of hospitalized patients with COVID-19.

Materials And Methods: PubMed, Scopus, Cochrane and MedRxiv databases were reviewed. Read More

View Article and Full-Text PDF

Use of ECG monitoring for adult patients taking high-risk QT interval-prolonging drugs in clinical practice: a systematic review protocol.

JBI Evid Synth 2021 May 28. Epub 2021 May 28.

JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia The Centre for Evidence-based Practice South Australia (CEPSA): A JBI Centre of Excellence, Adelaide, SA, Australia Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia.

Objective: To determine the rates of electrocardiogram use in adult patients taking high-risk QT interval-prolonging drugs in clinical settings. This review will determine the extent of ECG monitoring being used to mitigate risk of drug-induced QT prolongation.

Introduction: High-risk QT interval-prolonging drugs pose a well-established risk of cardiac arrhythmia, including torsades de pointes, among other serious long QT syndromes, which can be fatal. Read More

View Article and Full-Text PDF

Measuring the QT interval on the go.

Cardiol J 2021 ;28(3):358-359

Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Foothills Medical Center, Calgary, Alberta, Canada.

View Article and Full-Text PDF

Fluconazole-associated QT interval prolongation and Torsades de Pointes in a paediatric patient.

Cardiol Young 2021 May 24:1-3. Epub 2021 May 24.

Department of Child Health and Diseases, Unit of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.

"Torsades de pointes", a life-threatening rhythm disorder, is a polymorphic ventricular tachycardia that usually develops in association with a prolonged QT interval. Fluconazole, an anti-fungal drug, may also induce QT prolongation, in some cases subsequent torsades de pointes. Herein, we report a 16-year-old female presenting "torsades de pointes" after administration of fluconazole and rapidly improved upon cessation of the drug. Read More

View Article and Full-Text PDF

Exploration of Interactions Between Potential COVID-19 Antiviral Treatments and the Pore of the hERG Potassium Channel-A Drug Antitarget.

Front Cardiovasc Med 2021 4;8:645172. Epub 2021 May 4.

School of Physiology, Pharmacology and Neuroscience, University of Bristol, Biomedical Sciences Building, University Walk, Bristol, United Kingdom.

In the absence of SARS-CoV-2 specific antiviral treatments, various repurposed pharmaceutical approaches are under investigation for the treatment of COVID-19. Antiviral drugs considered for this condition include atazanavir, remdesivir, lopinavir-ritonavir, and favipiravir. Whilst the combination of lopinavir and ritonavir has been previously linked to prolongation of the QT interval on the ECG and risk of arrhythmia, less is known in this regard about atazanavir, remdesivir, and favipiravir. Read More

View Article and Full-Text PDF

Development of a Patient-Specific p.D85N-KCNE1 Induced Pluripotent Stem Cell-Derived Cardiomyocyte Model for Drug-Induced Long QT Syndrome.

Circ Genom Precis Med 2021 May 18. Epub 2021 May 18.

Departments of Cardiovascular Medicine (Division of Heart Rhythm Services), Pediatric and Adolescent Medicine (Division of Pediatric Cardiology), and Molecular Pharmacology & Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory), Mayo Clinic, Rochester, MN.

- Prior epidemiological studies demonstrated that the p.D85N-KCNE1 common variant reduces repolarization reserve and predisposes to drug-induced QT prolongation/torsades de pointes. We sought to develop a cellular model for drug-induced long QT syndrome (DI-LQTS) using a patient-specific induced pluripotent stem cell-derived cardiomyocyte (iPSC-CM). Read More

View Article and Full-Text PDF

Cardiac TdP risk stratification modelling of anti-infective compounds including chloroquine and hydroxychloroquine.

R Soc Open Sci 2021 Apr 13;8(4):210235. Epub 2021 Apr 13.

Department of Pharmacology, University of Oxford, Oxford, UK.

Hydroxychloroquine (HCQ), the hydroxyl derivative of chloroquine (CQ), is widely used in the treatment of rheumatological conditions (systemic lupus erythematosus, rheumatoid arthritis) and is being studied for the treatment and prevention of COVID-19. Here, we investigate through mathematical modelling the safety profile of HCQ, CQ and other QT-prolonging anti-infective agents to determine their risk categories for (TdP) arrhythmia. We performed safety modelling with uncertainty quantification using a risk classifier based on the qNet , a measure of the net charge carried by major currents during the action potential under inhibition of multiple ion channels by a compound. Read More

View Article and Full-Text PDF

Modulating the voltage sensor of a cardiac potassium channel shows antiarrhythmic effects.

Proc Natl Acad Sci U S A 2021 May;118(20)

Department of Biomedical Engineering, Washington University, St. Louis, MO 63130;

Cardiac arrhythmias are the most common cause of sudden cardiac death worldwide. Lengthening the ventricular action potential duration (APD), either congenitally or via pathologic or pharmacologic means, predisposes to a life-threatening ventricular arrhythmia, Torsade de Pointes. I (KCNQ1+KCNE1), a slowly activating K current, plays a role in action potential repolarization. Read More

View Article and Full-Text PDF

Abiraterone acetate-associated QT prolongation and torsades de pointes: Postmarketing cases reported to FDA.

J Oncol Pharm Pract 2021 May 14:10781552211015794. Epub 2021 May 14.

Division of Pharmacovigilance, Office of Surveillance and Epidemiology, U.S. Food and Drug Administration, Silver Spring, MD, USA.

View Article and Full-Text PDF

Severe Bradycardia Increases the Incidence and Severity of Torsade de Pointes Arrhythmias by Augmenting Preexistent Spatial Dispersion of Repolarization in the CAVB Dog Model.

Front Physiol 2021 26;12:642083. Epub 2021 Apr 26.

Department of Medical Physiology, Universitair Medisch Centrum Utrecht, Utrecht, Netherlands.

Introduction: Torsade de pointes arrhythmias (TdP) in the chronic atrioventricular block (CAVB) dog model result from proarrhythmic factors, which trigger TdP and/or reinforce the arrhythmic substrate. This study investigated electrophysiological and arrhythmogenic consequences of severe bradycardia for TdP.

Methods: Dofetilide (25 μg/kg per 5 min) was administered to eight anesthetized, idioventricular rhythm (IVR) remodeled CAVB dogs in two serial experiments: once under 60 beats per minute (bpm), right ventricular apex paced (RVA60) conditions, once under more bradycardic IVR conditions. Read More

View Article and Full-Text PDF

Cardiovascular Safety of Hydroxychloroquine in Veterans with Rheumatoid Arthritis.

Arthritis Rheumatol 2021 May 10. Epub 2021 May 10.

Veterans Affairs Medical Center, Washington, DC, USA.

Objective: Hydroxychloroquine (HCQ) may prolong the QT interval, a risk factor for torsade de pointes, a potentially fatal ventricular arrhythmia. We examined the cardiovascular safety of HCQ in patients with rheumatoid arthritis (RA).

Methods: We conducted an active comparator safety study of HCQ in a propensity score-matched cohort of 8852 Veterans newly diagnosed with RA between October 1, 2001, and December 31, 2017. Read More

View Article and Full-Text PDF

"Second line medications" for supraventricular arrhythmias in children: In-hospital efficacy and adverse events during treatment initiation of sotalol and flecainide.

J Cardiovasc Electrophysiol 2021 May 9. Epub 2021 May 9.

Department of Pediatrics, Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.

Introduction: Sotalol and flecainide are used as second line agents in children for the treatment of supraventricular arrhythmias (SA) refractory to anti-beta adrenergic antiarrhythmics or digoxin. Efficacy and adverse events in this cohort have not been well described. Here, we report our institutional experience of second line treatment initiation for SA in children. Read More

View Article and Full-Text PDF

Torsades de pointes episode in a woman with high-grade fever and inflammatory activation: A case report.

World J Clin Cases 2021 Apr;9(12):2899-2907

Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.

Background: QT interval prolongation can induce torsades de pointes (TdP), a potentially fatal ventricular arrhythmia. Recently, an increasing number of non-cardiac drugs have been found to cause QT prolongation and/or TdP onset. Moreover, recent findings have demonstrated the key roles of systemic inflammatory activation and fever in promoting long-QT syndrome (LQTS) and TdP development. Read More

View Article and Full-Text PDF

Predicting QT interval prolongation in patients diagnosed with the 2019 novel coronavirus infection.

Ann Noninvasive Electrocardiol 2021 May 7:e12853. Epub 2021 May 7.

Department of Internal Medicine, Ascension St. John Hospital, Detroit, MI, USA.

Introduction: 2019 novel coronavirus (COVID-19) patients frequently develop QT interval prolongation that predisposes them to Torsades de Pointes and sudden cardiac death. Continuous cardiac monitoring has been recommended for any COVID-19 patient with a Tisdale Score of seven or more. This recommendation, however, has not been validated. Read More

View Article and Full-Text PDF

Use of automated patch clamp in cardiac safety assessment: past, present and future perspectives.

J Pharmacol Toxicol Methods 2021 May 5;110:107072. Epub 2021 May 5.

North Stonington, CT, USA.

There is no doubt that automated patch clamp (APC) technology has revolutionized research in biomedical science. High throughput ion channel screening is now an integral part of the development and safety profiling of the majority of new chemical entities currently developed to address unmet medical needs. The increased throughput it provides has significantly improved the ability to overcome the time-consuming, low throughput bottlenecks resulting from the more conventional manual patch clamp method, considered the 'gold standard', for studying ion channel function and pharmacology. Read More

View Article and Full-Text PDF

Olfactory Distraction for Management of Nausea in Palliative Care Patients.

Am J Hosp Palliat Care 2021 May 6:10499091211015957. Epub 2021 May 6.

Division of Geriatrics and Palliative Medicine, Donald and Barbara Zucker School of Medicine, Northwell Health, New York, NY, USA.

Nausea is one of the most common and debilitating symptoms Palliative Care patients experience. This can be caused by the life-limiting illness itself, its complications, or its treatments. While there are many options for management, including anti-emetics and motility agents, patients may develop refractory nausea or even intolerance to these treatments. Read More

View Article and Full-Text PDF

Inflammation as a Risk Factor in Cardiotoxicity: An Important Consideration for Screening During Drug Development.

Front Pharmacol 2021 19;12:598549. Epub 2021 Apr 19.

Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States.

Numerous commonly prescribed drugs, including antiarrhythmics, antihistamines, and antibiotics, carry a proarrhythmic risk and may induce dangerous arrhythmias, including the potentially fatal Torsades de Pointes. For this reason, cardiotoxicity testing has become essential in drug development and a required step in the approval of any medication for use in humans. Blockade of the hERG K channel and the consequent prolongation of the QT interval on the ECG have been considered the gold standard to predict the arrhythmogenic risk of drugs. Read More

View Article and Full-Text PDF

A Novel Mutation in the KCNH2 Gene Associatedwith Long QT Syndrome: A Case Report.

Kelan Zha Qiang Ye

Ann Clin Lab Sci 2021 Mar;51(2):258-261

Department of Cardiology, The Affiliated Hospital of Southwest Medical University, China

Objective: Long QT syndrome is a cardiovascular disease with a prolonged QT interval.

Case Report: We report a 22-year-old woman presenting with frequent syncopal episodes two months after childbirth. Electrocardiography showed a sinus rhythm, QT interval prolongation, and Torsade de Pointes. Read More

View Article and Full-Text PDF

Torsade de pointes associated with chloroquine, hydroxychloroquine, and azithromycin: a retrospective analysis of individual case safety reports from VigiBase.

Eur J Clin Pharmacol 2021 May 3. Epub 2021 May 3.

Department of Medicine, University of Valencia, INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain.

Purpose: To analyze the cases of torsade de pointes (TdP) and related symptoms reported in association with chloroquine (CQ), hydroxychloroquine (HCQ), and azithromycin (AZT) to the World Health Organization (WHO) global database of individual case safety reports (ICSRs) for drug monitoring (VigiBase) using qualitative and quantitative pharmacovigilance approaches.

Methods: The main characteristics of the ICSRs reporting TdP with CQ, HCQ, and AZT have been summarized. Co-reported drugs with risk to cause QT prolongation have been described. Read More

View Article and Full-Text PDF

Cardiac arrhythmias in patients with COVID-19: Lessons from 2300 telemetric monitoring days on the intensive care unit.

J Electrocardiol 2021 May-Jun;66:102-107. Epub 2021 Apr 16.

DZHK (German Center of Cardiovascular Research), partner site Berlin, Germany; Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.

Background: Patients with COVID-19 seem to be prone to the development of arrhythmias. The objective of this trial was to determine the characteristics, clinical significance and therapeutic consequences of these arrhythmias in COVID-19 patients requiring intensive care unit (ICU) treatment.

Methods And Results: A total of 113 consecutive patients (mean age 64. Read More

View Article and Full-Text PDF

Hydroxyzine-induced Torsade de Pointes in a Patient with Complete Atrioventricular Block.

Intern Med 2021 Apr 26. Epub 2021 Apr 26.

Division of Cardiology, Shimane University Faculty of Medicine, Japan.

An 82-year-old woman was admitted to our hospital because of dyspnea and bradycardia during exertion. Electrocardiography revealed complete atrioventricular block. During pacemaker implantation, a small dose (12. Read More

View Article and Full-Text PDF

Cardiac Corrected QT Interval Changes Among Patients Treated for COVID-19 Infection During the Early Phase of the Pandemic.

JAMA Netw Open 2021 04 1;4(4):e216842. Epub 2021 Apr 1.

Division of Cardiology, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York.

Importance: Critical illness, a marked inflammatory response, and viruses such as SARS-CoV-2 may prolong corrected QT interval (QTc).

Objective: To evaluate baseline QTc interval on 12-lead electrocardiograms (ECGs) and ensuing changes among patients with and without COVID-19.

Design, Setting, And Participants: This cohort study included 3050 patients aged 18 years and older who underwent SARS-CoV-2 testing and had ECGs at Columbia University Irving Medical Center from March 1 through May 1, 2020. Read More

View Article and Full-Text PDF

Successful Management of Refractory Torsades De Pointes Due to Drug-Induced Long QT Syndrome Guided by Point-of-Care Monitoring of Ionized Magnesium.

Cureus 2021 Mar 17;13(3):e13939. Epub 2021 Mar 17.

Department of Anesthesiology, Saitama Medical Center, Saitama Medical University, Kawagoe, JPN.

Ionized magnesium (iMg) is the physiologically active fraction, although total magnesium (tMg) is often used clinically because a dedicated electrode is required to measure the iMg concentration. The tMg concentration is not correlated with the iMg concentration, especially in severely ill patients. In this report, a case of refractory torsades de pointes (TdP) due to drug-induced long QT syndrome was successfully treated with high-dose magnesium sulfate guided by point-of-care monitoring of the iMg concentration. Read More

View Article and Full-Text PDF

Cardiac hERG K Channel as Safety and Pharmacological Target.

Handb Exp Pharmacol 2021 Apr 8. Epub 2021 Apr 8.

Department of Pharmacology, Hebei Medical University, The Key Laboratory of New Drug Pharmacology and Toxicology, Hebei, China.

The human ether-á-go-go related gene (hERG, KCNH2) encodes the pore-forming subunit of the potassium channel responsible for a fast component of the cardiac delayed rectifier potassium current (I). Outward I is an important determinant of cardiac action potential (AP) repolarization and effectively controls the duration of the QT interval in humans. Dysfunction of hERG channel can cause severe ventricular arrhythmias and thus modulators of the channel, including hERG inhibitors and activators, continue to attract intense pharmacological interest. Read More

View Article and Full-Text PDF

Naturally occurring torsades de pointes and QT interval prolongation in a domestic cat.

J Vet Cardiol 2021 Mar 3;35:42-47. Epub 2021 Mar 3.

Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, 95616, USA. Electronic address:

A 10-year-old male American Shorthair cat was presented after a witnessed syncopal event. A Holter monitor demonstrated a long QT interval and revealed a rhythm characteristic of torsades de pointes (TdP) coincident with a bout of syncope. On subsequent Holter monitor recordings, sotalol did not prolong the QT interval further and did not reduce the severity of the underlying ventricular tachyarrhythmias, but no TdP was identified. Read More

View Article and Full-Text PDF

Survey concerning internal medicine physicians and prolonged QT interval: Knowledge and treatment practices.

World J Cardiol 2021 Mar;13(3):42-45

Department of Pharmacy Practice, Drake University College of Pharmacy and Health Sciences, Des Moines, IA 50311, United States.

Prolongation of the QT interval is associated with adverse cardiac events specifically Torsades de pointes (TdP). There are multiple mediations that have a known, possible, or conditional risk for prolonged QT interval, but general practitioners' knowledge of these medications is unknown. We conducted a survey to assess internal medicine (IM) providers' knowledge of risk factors and medications associated with prolonged QT as well as provider experience and comfort when treating patients with prolonged QT. Read More

View Article and Full-Text PDF