5,174 results match your criteria Torsade de Pointes


Case Report: An Unusual Case of Pheochromocytoma.

Front Cardiovasc Med 2022 10;9:919500. Epub 2022 Jun 10.

Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China.

Pheochromocytoma is a benign catecholamine secreting tumor, which is rare and originates from the adrenal gland. It has been known for a wide range of clinical manifestations and can mimic other difficult-to-diagnose diseases. Here, we report a female patient with acquired long QT syndrome, which is a rare complication of pheochromocytoma. Read More

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Contribution of hemodynamic side effects and associated autonomic reflexes to ventricular arrhythmias triggering by torsadogenic hERG blocking drugs.

Br J Pharmacol 2022 Jun 24. Epub 2022 Jun 24.

Laboratoire PHYMEDEXP, Université de Montpellier, INSERM, CNRS, Montpellier cedex, France.

Background And Purposes: Several hERG blocking drugs known for their propensity to trigger Torsades de Pointes (TdP) were reported to induce a sympatho-vagal coactivation and to enhance High Frequency heart rate (HFHR) and QT oscillations (HFQT) from telemetric data. The present work aims to characterise the underlying mechanism(s) leading to these autonomic changes.

Experimental Approach: Effects of 15 torsadogenic hERG blocking drugs (astemizole, chlorpromazine, cisapride, droperidol, ibutilide, dofetilide, haloperidol, moxifloxacin, pimozide, quinidine, risperidone, sotalol, sertindole, terfenadine, thioridazine) were assessed by telemetry in beagle dogs. Read More

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Resuscitated Sudden Cardiac Arrest of a Neonate with Congenital LQT Syndrome-Associated Torsades de Pointes: A Case Report and Literature Review.

J Cardiovasc Dev Dis 2022 Jun 9;9(6). Epub 2022 Jun 9.

Department of Pediatric Cardiology, Mackay Children's Hospital, Taipei 104217, Taiwan.

Sudden infant death syndrome (SIDS), the most common cause of infant death in developed countries, is attributed to diverse trigger factors. Malignant cardiac dysrhythmias are potentially treatable etiologies, and congenital long QT syndrome (LQTS) is the most common cardiac ionic channelopathy confronted. β-Blockers or class Ib agents are the drugs of choice for the control of arrhythmias, and an implantable cardioverter defibrillator (ICD) should be considered for secondary prevention in survivors of lethal cardiac death. Read More

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Initiation of ventricular arrhythmia in the acquired long QT syndrome.

Cardiovasc Res 2022 Jun 21. Epub 2022 Jun 21.

Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK.

Aims: Long QT syndrome (LQTS) carries a risk of life-threatening polymorphic ventricular tachycardia (Torsades de Pointes, TdP) and is a major cause of premature sudden cardiac death. TdP is induced by R-on-T premature ventricular complexes (PVCs), thought to be generated by cellular early-afterdepolarisations (EADs). However, EADs in tissue require cellular synchronisation, and their role in TdP induction remains unclear. Read More

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Case Report: Torsade de Pointes Induced by the Third-Generation Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor Osimertinib Combined With Litsea Cubeba.

Front Cardiovasc Med 2022 31;9:903354. Epub 2022 May 31.

Department of Pharmacy, Lishui Central Hospital, Lishui, China.

Torsades de Pointes (TdP) occurred in a 68-year-old female with epidermal growth factor receptor (EGFR) mutant lung cancer administered osimertinib, the third-generation EGFR tyrosine kinase inhibitor (TKI). Electrocardiogram (ECG) recorded at Tdp showed QT prolongation (QTc = 515 ms), to which a Traditional Chinese Medicine (TCM) named "Litsea Cubeba" may have contributed. After discontinuation of osimertinib and Litsea Cubeba, magnesium supplementation, potassium supplementation, lidocaine infusion, and the pacemaker frequency adjustment, Tdp terminated. Read More

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The genetics of drug-induced QT prolongation: evaluating the evidence for pharmacodynamic variants.

Pharmacogenomics 2022 Jun 14;23(9):543-557. Epub 2022 Jun 14.

Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI 48109, USA.

Drug-induced long QT syndrome (diLQTS) is an adverse effect of many commonly prescribed drugs, and it can increase the risk for lethal ventricular arrhythmias. Genetic variants in pharmacodynamic genes have been associated with diLQTS, but the strength of the evidence for each of those variants has not yet been evaluated. Therefore, the purpose of this review was to evaluate the strength of the evidence for pharmacodynamic genetic variants associated with diLQTS using a novel, semiquantitative scoring system modified from the approach used for congenital LQTS. Read More

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Considering population variability of electrophysiological models improves the in silico assessment of drug-induced torsadogenic risk.

Comput Methods Programs Biomed 2022 Jun 3;221:106934. Epub 2022 Jun 3.

Centro de Investigación e Innovación en Bioingeniería (Ci(2)B), Universitat Politècnica de València, camino de Vera, s/n, Valencia 46022, Spain. Electronic address:

Background And Objective: In silico tools are known to aid in drug cardiotoxicity assessment. However, computational models do not usually consider electrophysiological variability, which may be crucial when predicting rare adverse events such as drug-induced Torsade de Pointes (TdP). In addition, classification tools are usually binary and are not validated using an external data set. Read More

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COVID-19 vaccination and Torsades de Pointes.

HeartRhythm Case Rep 2022 Jun 2. Epub 2022 Jun 2.

Honorary professor, Dr DY Patil University, Pune, India.

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Reply to Letter to the Editor for COVID-19 vaccination and Torsades de Pointes.

HeartRhythm Case Rep 2022 Jun 2. Epub 2022 Jun 2.

Department of Cardiology, MercyOne Waterloo Medical Center, Waterloo, Iowa.

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Takotsubo Syndrome and Sudden Cardiac Death.

Angiology 2022 Jun 6:33197221105757. Epub 2022 Jun 6.

First Department of Cardiology, Athens University School of Medicine, Athens, Greece.

Takotsubo syndrome (TTS), triggered by intense emotional or physical stress, occurring most commonly in post-menopausal women, presents as an ST-elevation myocardial infarction (MI). Cardiovascular complications occur in almost half the patients with TTS, and the inpatient mortality is comparable to MI (4-5%) owing to cardiogenic shock, myocardial rupture, or life-threatening arrhythmias. Thus, its prognosis is not as benign as previously thought, as it may cause mechanical complications (cardiac rupture) and potentially lethal arrhythmias and sudden cardiac death (SCD). Read More

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Clinician Responses to a Clinical Decision Support Advisory for High Risk of Torsades de Pointes.

J Am Heart Assoc 2022 Jun 3;11(11):e024338. Epub 2022 Jun 3.

College of Pharmacy University of Utah Salt Lake City UT.

Background Torsade de pointes (TdP) is a potentially fatal cardiac arrhythmia that is often drug induced. Clinical decision support (CDS) may help minimize TdP risk by guiding decision making in patients at risk. CDS has been shown to decrease prescribing of high-risk medications in patients at risk of TdP, but alerts are often ignored. Read More

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Vandetanib-Induced Hyponatremia and Torsades De Pointes: A Case Report.

Cureus 2022 Apr 28;14(4):e24556. Epub 2022 Apr 28.

Cardiovascular Disease, BronxCare Health System/Icahn School of Medicine at Mount Sinai, New York City, USA.

Medullary thyroid cancer (MTC) is a neuroendocrine tumor of the parafollicular cells of the thyroid gland. The prognosis is very poor in patients with advanced MTC. Vandetanib was approved for advanced MTC after randomized control trials showed that it had therapeutic efficacy and considerably prolonged progression-free survival. Read More

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Pharmacological characterisation of electrocardiogram J-T interval in conscious Guinea pigs.

Eur J Pharmacol 2022 Jul 29;927:175065. Epub 2022 May 29.

Watarase Research Center, Kyorin Pharmaceutical Co., Ltd., 1848, Nogi, Nogi-machi, Shimotsuga-gun, Tochigi, 329-0114, Japan.

Drug-induced human ether-à-go-go-related gene (hERG) channel block and QT interval prolongation increase torsade de pointes (TdP) risk. However, some drugs block hERG channels and prolong QT interval with low TdP risk, likely because they block additional inward currents. We investigated the utility of J-T interval, a novel biomarker of inward current block and TdP risk, in conscious telemetered guinea pigs. Read More

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Safety of Short-Term Treatments with Oral Chloroquine and Hydroxychloroquine in Patients with and without COVID-19: A Systematic Review.

Pharmaceuticals (Basel) 2022 May 21;15(5). Epub 2022 May 21.

Pharmacy Department, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain.

Chloroquine (CQ) and hydroxychloroquine (HCQ) have recently become the focus of global attention as possible treatments for Coronavirus Disease 2019 (COVID-19). The current systematic review aims to assess their safety in short treatments (≤14 days), whether used alone or in combination with other drugs. Following the PRISMA and SWiM recommendations, a search was conducted using four health databases for all relevant English-, Chinese-, and Spanish-language studies from inception through 30 July 2021. Read More

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Harmless herbs? A case report of acquired long QT syndrome and torsades de pointes in a patient taking herbal supplements.

HeartRhythm Case Rep 2022 May 16;8(5):309-312. Epub 2022 May 16.

Department of Cardiology, University Hospital of Geneva, Geneva, Switzerland.

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Pharmacometric and Electrocardiographic Evaluation of Chloroquine and Azithromycin in Healthy Volunteers.

Clin Pharmacol Ther 2022 May 22. Epub 2022 May 22.

Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

Chloroquine and azithromycin were developed in combination for the preventive treatment of malaria in pregnancy, and more recently were proposed as coronavirus disease 2019 (COVID-19) treatment options. Billions of doses of chloroquine have been administered worldwide over the past 70 years but concerns regarding cardiotoxicity, notably the risk of torsades de pointes (TdP), remain. This investigation aimed to characterize the pharmacokinetics and electrocardiographic effects of chloroquine and azithromycin observed in a large previously conducted healthy volunteer study. Read More

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A case of torsades de pointes due to takotsubo cardiomyopathy after common atrial flutter ablation.

J Cardiol Cases 2022 May 25;25(5):275-278. Epub 2021 Nov 25.

Ishikawa Prefectural Central Hospital, Department of Cardiology, 2-1 Kuratsuki Higashi, Kanazawa City, Ishikawa Prefecture, Japan.

Takotsubo cardiomyopathy (TCM) is a transient acute cardiac disorder often associated with QT prolongation, but this rarely leads to torsades de pointes (TdP). Additionally, it is a rare complication of catheter ablation. Here we report a case of TCM that developed after catheter ablation for common atrial flutter, which led to TdP. Read More

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Proarrhythmic risk assessment of drugs by dV /dt shapes using the convolutional neural network.

CPT Pharmacometrics Syst Pharmacol 2022 May 17;11(5):653-664. Epub 2022 May 17.

Department of IT Convergence Engineering, Kumoh National Institute of Technology, Gumi, Korea.

Comprehensive in vitro Proarrhythmia Assay (CiPA) projects for assessing proarrhythmic drugs suggested a logistic regression model using qNet as the Torsades de Pointes (TdP) risk assessment biomarker, obtained from in silico simulation. However, using a single in silico feature, such as qNet, cannot reflect whole characteristics related to TdP in the entire action potential (AP) shape. Thus, this study proposed a deep convolutional neural network (CNN) model using differential action potential shapes to classify three proarrhythmic risk levels: high, intermediate, and low, considering both characteristics related to TdP not only in the depolarization phase but also the repolarization phase of AP shape. Read More

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Congenital Long QT Syndrome: A Review of Genetic and Pathophysiologic Etiologies, Phenotypic Subtypes and Clinical Management.

Cardiol Rev 2022 May 16. Epub 2022 May 16.

Departments of Medicine and Cardiology, New York Medical College/ Westchester Medical Center, Valhalla, NY.

Congenital Long QT Syndrome (CLQTS) is the most common inherited arrhythmia. The QT interval, which marks the duration of ventricular depolarization and repolarization in the myocardium, can be prolonged due to mutations in genes coding for the ion channel proteins that govern the cardiac action potential. The lengthening of the QT interval can lead to a wide range of clinical symptoms, including seizures, torsades de pointes, and fatal arrhythmias. Read More

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Hydroxychloroquine safety in Covid-19 vs non-Covid-19 patients: analysis of differences and potential interactions.

Expert Opin Drug Saf 2022 May 19:1-9. Epub 2022 May 19.

Centro de Estudios sobre la Seguridad de los Medicamentos (CESME). Departamento de Biología Celular, Histología, Farmacología y Genética. Facultad de Medicina. Universidad de Valladolid, Valladolid, Spain.

Background: The use of hydroxychloroquine (HCQ) in the first COVID-19 epidemic wave raised safety concerns.

Research Design And Methods: Adverse reactions (ADR) suspected to be induced by HCQ and submitted to the Spanish Pharmacovigilance Database were studied. A disproportionality analysis was performed to determine adverse effects reported in non-Covid and Covid patients. Read More

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Identifying Acute Cardiac Hazard in Early Drug Discovery Using a Calcium Transient High-Throughput Assay in Human-Induced Pluripotent Stem Cell-Derived Cardiomyocytes.

Front Physiol 2022 25;13:838435. Epub 2022 Apr 25.

Global Safety Pharmacology, Predictive, Investigative and Translational Toxicology, Nonclinical Safety, Beerse, Belgium.

Early identification of cardiac risk is essential for reducing late-stage attrition in drug development. We adapted the previously published cardiac hazard risk-scoring system using a calcium transient assay in human stem cell-derived CMs for the identification of cardiac risks recorded from the new hiPSC-CM line and investigated its predictivity and translational value based on the screening of a large number of reference and proprietary compounds. Evaluation of 55 reference drugs provided the translation of various pharmacological effects into a single hazard label (no, low, high, or very high hazard) using a Ca-sensitive fluorescent dye assay recorded by -by FDSS/µCell Functional Drug Screening System (Hamamatsu on hiPSC-CM line (FCDI iCell Cardiomyocytes). Read More

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Atrial pacing to suppress ventricular arrhythmias in the critically ill patients: a case report.

Eur Heart J Case Rep 2022 May 16;6(5):ytac163. Epub 2022 Apr 16.

Cardiology Department, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK.

Background: Atrial and ventricular arrhythmias are common in the critically ill due to a variety of factors including sepsis, myocardial ischaemia, renal dysfunction, and electrolyte disturbances. Anti-arrhythmic medications can be useful to control arrhythmias but can result in bradycardia and haemodynamic compromise. A paced atrial rhythm alongside normal atrioventricular conduction can be helpful to treat bradycardia, prevent arrhythmias, and support cardiac output. Read More

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Overt long QT syndrome in children presenting with seizure disorders in Pakistan.

Ann Pediatr Cardiol 2021 Oct-Dec;14(4):485-489. Epub 2022 Mar 25.

Department of Pediatric Cardiology, Children Hospital Faisalabad, Punjab, Pakistan.

Background And Objective: The long QT syndrome (LQTS) is a repolarization defect of heart involving potassium linked channels and it usually manifests clinically as seizures, syncope, or sudden cardiac death syndrome in children secondary to its characteristic ventricular tachy-arrhythmia like torsades de pointes. The reason behind epilepsy or seizures like activity in this disease is the sequelae of prolonged cerebral hypoperfusion secondary to the cardiac dysrhythmia. The aim of study is to look for clinical spectrum and risk factors associated with LQTS among children presenting with epilepsy, which can predict the early diagnosis of LQTS. Read More

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Contemporary maternal and fetal outcomes in the treatment of LQTS during pregnancy: Is nadolol bad for the fetus?

Heart Rhythm 2022 May 5. Epub 2022 May 5.

Department of Pediatric Cardiology, Cleveland Clinic Children's, Cleveland, Ohio. Electronic address:

Background: β-Blocker therapy, specifically nadolol, is the recommended treatment for long QT syndrome (LQTS). Previous studies assessing maternal and fetal outcomes were published before the nadolol era.

Objective: The purpose of this study was to examine contemporary maternal and fetal outcomes in the treatment of LQTS during pregnancy. Read More

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A Case of Abiraterone-Related Hypokalemia Leading to Torsades de Pointes and Cardiac Arrest.

Cureus 2022 Mar 31;14(3):e23678. Epub 2022 Mar 31.

Emergency Medicine, University of South Florida, Tampa, USA.

Abiraterone acetate is an androgen-depriving therapy (ADT) that is highly effective for treating castration-resistant prostate cancer (CRPC). By inhibiting CYP17, abiraterone can induce a state of mineralocorticoid excess, which is associated with profound hypokalemia. We present a case of abiraterone-related hypokalemia which led to torsades de pointes (TdP) and ventricular fibrillation (VF). Read More

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Early afterdepolarizations and electrical storm after cardioversion for atrial fibrillation.

HeartRhythm Case Rep 2022 Apr 17;8(4):254-258. Epub 2022 Jan 17.

Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia.

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A tale of 2 torsades: How to approach a patient with torsades de pointes and distinguish between classical and pseudo-torsades de pointes.

HeartRhythm Case Rep 2022 Apr 15;8(4):305-308. Epub 2022 Apr 15.

Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.

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Drug Interactions Affecting Antiarrhythmic Drug Use.

Circ Arrhythm Electrophysiol 2022 May 2;15(5):e007955. Epub 2022 May 2.

Kansas City Heart Rhythm Institute, KS (D.L., R.G.).

Antiarrhythmic drugs (AAD) play an important role in the management of arrhythmias. Drug interactions involving AAD are common in clinical practice. As AADs have a narrow therapeutic window, both pharmacokinetic as well as pharmacodynamic interactions involving AAD can result in serious adverse drug reactions ranging from arrhythmia recurrence, failure of device-based therapy, and heart failure, to death. Read More

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Mexiletine effectively prevented refractory Torsades de Pointes and ventricular fibrillation in a patient with congenital type 2 long QT syndrome.

J Cardiovasc Electrophysiol 2022 Apr 30. Epub 2022 Apr 30.

Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.

We report a 28-year-old female patient with congenital type 2 long QT syndrome (LQTS) in which mexiletine shortened corrected QT interval (QTc) and effectively prevented refractory Torsade de Pointes (TdP) and ventricular fibrillation (VF). She developed TdP and VF, and was subsequently diagnosed with congenital type 2 LQTS. She had refractory TdP and VF every day despite medical therapy including β-blocker. Read More

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Effects of Serum and Compound Preparation Methods on Delayed Repolarization Evaluation with Human iPSC-CMs.

Toxicol Sci 2022 Apr 27. Epub 2022 Apr 27.

Division of Systems Biology, National Center for Toxicological Research, U.S. Food and Drug Administration, 3900 NCTR Road, Jefferson, 72079, AR USA.

Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) have been widely used in the Comprehensive In Vitro Proarrhythmia Assay (CiPA). The notable difference of the electrophysiological (EP) responses of hiPSC-CMs in serum and serum-free media is puzzling and may impact regulatory decision making on the cardiac safety of candidate drugs in inducing QT prolongation and torsade de pointes (TdP). In this study, we compared the EP responses of hiPSC-CMs to 10 CiPA compounds and moxifloxacin in serum and serum-free media; explained the potential reason behind the different EP responses ─ abiotic compound loss to plastic tubes/plates of hydrophobic compounds prepared in serum-free media; and investigated the impact of compound preparation methods on drug bioavailability in exposure media, which affects the TdP risk prediction of drugs tested in serum-containing and serum-free media. Read More

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