4,573 results match your criteria Torsade de Pointes


Assessing drug-induced long QT and proarrhythmic risk using human stem cell-derived cardiomyocytes in a Ca2+ imaging assay: Evaluation of 28 CiPA compounds at three test sites.

Toxicol Sci 2019 Apr 24. Epub 2019 Apr 24.

Janssen Pharmaceutica NV (J&J), Turnhoutseweg 30, Beerse, Belgium.

Introduction: The goal of this research consortium including Janssen, MSD, Ncardia, FNCR/LBR and HESI was to evaluate the utility of an additional in vitro assay technology to detect potential drug-induced long QT and torsade de pointes (TdP) risk by monitoring cytosolic free Ca2+ transients in human stem cell-derived cardiomyocytes (hSC-CMs).

Methods: The potential proarrhythmic risks of the 28 CiPA drugs linked to low, intermediate, and high clinical TdP risk were evaluated in a blinded manner using Ca2+ -sensitive fluorescent dye assay recorded from a kinetic plate reader system (Hamamatsu FDSS/µCell and FDSS7000) in 2D cultures of two commercially available hSC-CM lines (Cor.4U® and CDI iCell® Cardiomyocytes) at three different test sites. Read More

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http://dx.doi.org/10.1093/toxsci/kfz102DOI Listing

Citalopram and the KCNE1 D85N variant: a case report on the implications of a genetic modifier.

Eur Heart J Case Rep 2018 Dec 26;2(4):yty106. Epub 2018 Sep 26.

Department of Cardiology, Herlev-Gentofte Hospital, University Hospital Copenhagen, Herlev Ringvej 75, Copenhagen, Denmark.

Background: Prolongation of the QT interval on the electrocardiogram is clinically important due to the association with an increased risk of sudden cardiac death. A long QT interval may be genetically determined (congenital long QT syndrome) or be drug-induced long QT syndrome e.g. Read More

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http://dx.doi.org/10.1093/ehjcr/yty106DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426086PMC
December 2018

High Prevalence of Proarrhythmic Events in Patients With History of Atrial Fibrillation Undergoing a Rhythm Control Strategy: A Retrospective Study.

J Clin Med Res 2019 May 14;11(5):345-352. Epub 2019 Apr 14.

Division of Geriatrics, Clinic "S. Maria del Pozzo", via Pomigliano 40, Somma Vesuviana, Italy.

Background: A retrospective study was undertaken to evaluate the respective prevalence of proarrhythmic events depending on various therapeutic regimens within a population of patients with history of atrial fibrillation (AF) undergoing a rhythm control strategy.

Methods: Inclusion criterion was the presence of AF in the patient's clinical history, whose cardioversion had been followed by the adoption of rhythm control strategy. The primary endpoint was the determination of the respective prevalences of paradoxical arrhythmias in the various therapeutic groups. Read More

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http://dx.doi.org/10.14740/jocmr3805DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469886PMC

Guidelines for reporting case studies and series on drug-induced QT interval prolongation and its complications following acute overdose.

Clin Toxicol (Phila) 2019 Apr 24:1-9. Epub 2019 Apr 24.

j Department of Emergency Medicine , Hôpital Charles-Lemoyne , Greenfield Park, Canada.

Background: The assessment and management of patients with QT interval prolongation in poisoning requires an appropriate method of measuring and adjusting the QT interval for the heart rate (HR) in order to decide if the patient is at risk of life-threatening dysrhythmias, notably torsade de pointes (TdP). As the Clinical Toxicology Collaborative (CTC) workgroup reviewed the published literature on drug-induced QT interval prolongation in poisoning, it became obvious that many publications were missing essential data that were necessary to thoroughly assess and compare the evidence. The aim of this guidance document is to identify essential and ideal criteria required when reporting a case of drug-induced QT interval prolongation and/or TdP in poisoning. Read More

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http://dx.doi.org/10.1080/15563650.2019.1605077DOI Listing

Progesterone pretreatment reduces the incidence of drug-induced torsades de pointes in atrioventricular node-ablated isolated perfused rabbit hearts.

J Cardiovasc Electrophysiol 2019 Apr 21. Epub 2019 Apr 21.

Department of Medicine, Krannert Institute of Cardiology, School of Medicine, Indiana University, Indianapolis, Indiana.

Introduction: Higher progesterone concentrations are protective against drug-induced prolongation of ventricular repolarization. We tested the hypothesis that pretreatment with progesterone reduces the incidence of drug-induced torsades de pointes (TdP).

Methods And Results: Female New Zealand white rabbits (2. Read More

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http://dx.doi.org/10.1111/jce.13942DOI Listing

Recurrent idiopathic polymorphic ventricular tachycardia/ventricular fibrillation successfully treated by cardiac sympathetic denervation.

HeartRhythm Case Rep 2019 Apr 26;5(4):229-232. Epub 2019 Jan 26.

Division of Cardiovascular Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa.

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http://dx.doi.org/10.1016/j.hrcr.2019.01.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6453564PMC
April 2019
1 Read

Wide interindividual variability in cardiovascular toxicity of loperamide: A case report and review of literature.

HeartRhythm Case Rep 2019 Apr 14;5(4):221-224. Epub 2019 Jan 14.

Division of Electrophysiology, Department of Cardiology, St. John Hospital and Medical Center, Detroit, Michigan.

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http://dx.doi.org/10.1016/j.hrcr.2019.01.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6453448PMC
April 2019
2 Reads

Effects of Dexmedetomidine on Myocardial Repolarization in Children Undergoing General Anesthesia: A Randomized Controlled Trial.

Anesth Analg 2019 Apr 8. Epub 2019 Apr 8.

From the Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada.

Background: Dexmedetomidine is a highly selective α2-adrenergic agonist, which is increasingly used in pediatric anesthesia and intensive care. Potential adverse effects that have not been rigorously evaluated in children include its effects on myocardial repolarization, which is important given that the drug is listed as a possible risk factor for torsades de pointes. We investigated the effect of 3 different doses of dexmedetomidine on myocardial repolarization and transmural dispersion in children undergoing elective surgery with total IV anesthesia. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004135DOI Listing
April 2019
6 Reads

Comparison of QT Interval Measurement Methods and Correction Formulas in Atrial Fibrillation.

Am J Cardiol 2019 Mar 13. Epub 2019 Mar 13.

Stanford University, Division of Cardiovascular Medicine, Stanford, California. Electronic address:

Antiarrhythmic drugs used in atrial fibrillation (AF) cause QT prolongation and are associated with torsades de pointes, a deadly ventricular arrhythmia. No consensus exists on the optimal method of QT measurement or correction in AF. Therefore, we compared common methods to measure and correct QT in AF to identify the most accurate approach. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00029149193030
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http://dx.doi.org/10.1016/j.amjcard.2019.02.057DOI Listing
March 2019
7 Reads

ECG Diagnosis: Ibutilide-induced Torsade de Pointes.

Perm J 2019 ;23

Department of Emergency Medicine, Sacramento Medical Center, CA.

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http://dx.doi.org/10.7812/TPP/18-187DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380474PMC
January 2019
2 Reads

Pharmacist-Managed Inpatient Dofetilide Initiation Program: Description and Adherence Rate Post-Root Cause Analysis.

J Pharm Pract 2019 Apr 2:897190019834130. Epub 2019 Apr 2.

4 Department of Pharmacy Practice, Maine Medical Center, Portland, ME, USA.

The aim of this article is to describe the pharmacist-managed dofetilide initiation program at Maine Medical Center (MMC), assess the adherence rate to 8 core clinical metrics, and review adverse effects before and after a root cause analysis (RCA). Core clinical metrics included pharmacist note entered within 4 hours of dose administration, dose chosen correctly per renal function, QTc measurements obtained and reviewed 2 hours after each dose, appropriate dose adjustment per the most recent QTc measurement, documentation of patient education, and assessment of conduction abnormality, drug-drug interactions, and serum potassium and magnesium concentrations. The primary outcome was adherence rate to all 8 core clinical metrics before and after the RCA. Read More

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http://journals.sagepub.com/doi/10.1177/0897190019834130
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http://dx.doi.org/10.1177/0897190019834130DOI Listing
April 2019
5 Reads

ANK2 functionally interacts with KCNH2 aggravating long QT syndrome in a double mutation carrier.

Biochem Biophys Res Commun 2019 May 28;512(4):845-851. Epub 2019 Mar 28.

Department of Cardiology, Medical University Hospital Heidelberg, INF 410, D-69120, Heidelberg, Germany; DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, University of Heidelberg, INF 410, D-69120, Heidelberg, Germany. Electronic address:

Pathogenic long QT mutations often comprise high phenotypic variability and particularly variants in ANK2 (long QT syndrome 4) frequently lack QT prolongation. We sought to elucidate the genetic and functional background underlying the clinical diversity in a 3-generation family with different cardiac arrhythmias. Next-generation sequencing-based screening of patients with QT prolongation identified the index patient of the family carrying an ANK2-E1813K variant and a previously uncharacterized KCNH2-H562R mutation in a double heterozygous conformation. Read More

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http://dx.doi.org/10.1016/j.bbrc.2019.03.162DOI Listing
May 2019
1 Read

Assessment of proarrhythmic potential of drugs in optogenetically paced induced pluripotent stem cell-derived cardiomyocytes.

Toxicol Sci 2019 Mar 26. Epub 2019 Mar 26.

US Food and Drug Administration, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, Silver Spring, Maryland.

Background: Cardiac side-effects are one of the major reasons for failure of drugs during preclinical development. Induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) have been proposed as a model for predicting drug-induced arrhythmias under the Comprehensive in vitro Proarrhythmia Assay (CiPA) paradigm. Field potential duration (FPD) in spontaneously-beating iPSC-CMs is commonly corrected for beating rate using formulas originally derived from the clinical QT-RR relationship that have not been thoroughly validated for use with iPSC-CMs. Read More

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http://dx.doi.org/10.1093/toxsci/kfz076DOI Listing
March 2019
1 Read

QTc prolongation and Torsade de Pointes induced by extreme eperisone overdose.

Clin Toxicol (Phila) 2019 Mar 21:1-2. Epub 2019 Mar 21.

b Department of Pharmacy , Saitama Medical University Hospital , Saitama , Japan.

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http://dx.doi.org/10.1080/15563650.2019.1592186DOI Listing
March 2019
2 Reads

Summary of Torsades de Pointes (TdP) Reports Associated with Intravenous Drug Formulations Containing the Preservative Chlorobutanol.

Drug Saf 2019 Mar 19. Epub 2019 Mar 19.

AZCERT, 1822 E. Innovation Park Dr., Oro Valley, AZ, 85755, USA.

Introduction: Drug-induced torsades de pointes (TdP) is a potentially lethal ventricular arrhythmia that is associated with drugs that prolong the QT interval on the electrocardiogram (ECG) due to their interference with the cardiac potassium current, I. Intravenous (IV) formulations of methadone have been associated with TdP and contain the preservative chlorobutanol, which, like methadone, blocks I. The combinations of chlorobutanol with methadone or terfenadine, another I blocker, produce synergistic I block. Read More

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http://dx.doi.org/10.1007/s40264-019-00804-7DOI Listing
March 2019
3 Reads

QT Assessment in Early Drug Development: The Long and the Short of It.

Int J Mol Sci 2019 Mar 15;20(6). Epub 2019 Mar 15.

Cardiac Safety Services, Celerion, 2420 W Baseline Rd, Tempe, AZ 85283, USA.

The QT interval occupies a pivotal role in drug development as a surface biomarker of ventricular repolarization. The electrophysiologic substrate for QT prolongation coupled with reports of non-cardiac drugs producing lethal arrhythmias captured worldwide attention from government regulators eventuating in a series of guidance documents that require virtually all new chemical compounds to undergo rigorous preclinical and clinical testing to profile their QT liability. While prolongation or shortening of the QT interval may herald the appearance of serious cardiac arrhythmias, the positive predictive value of an abnormal QT measurement for these arrhythmias is modest, especially in the absence of confounding clinical features or a congenital predisposition that increases the risk of syncope and sudden death. Read More

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http://dx.doi.org/10.3390/ijms20061324DOI Listing
March 2019
1 Read

Donepezil - QT prolongation and torsades de pointes.

Clin Med (Lond) 2019 Mar;19(2):189

ST4 geriatric medicine and general internal medicine, Colchester, UK.

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http://dx.doi.org/10.7861/clinmedicine.19-2-189DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454374PMC

Altered mechano-electrical coupling: An underappreciated factor in sympathetically mediated torsades de pointes in the long QT syndrome.

Int J Cardiol 2019 Mar 4. Epub 2019 Mar 4.

Harvard Medical School, Beth Israel Deaconess Medical Center, Division of Cardiovascular Medicine, 99 Brookline Avenue, RN-301, Boston, MA 02215-3908, USA. Electronic address:

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http://dx.doi.org/10.1016/j.ijcard.2019.03.004DOI Listing
March 2019
1 Read

Implementation of a QTc-interval monitoring protocol by pharmacists to decrease cardiac risk in at-risk patients in an acute care inpatient psychiatric facility.

Ment Health Clin 2019 Mar 1;9(2):82-87. Epub 2019 Mar 1.

Pharmacy Resident, Barnabas Health Behavioral Health Center, Toms River, New Jersey; Ernest Mario School of Pharmacy at Rutgers, The State University of New Jersey, New Brunswick, New Jersey.

Introduction: Many medications commonly prescribed in psychiatric hospitals can cause QTc-interval prolongation, increasing a patient's risk for torsades de pointes and sudden cardiac death. There is little guidance in the literature to determine when an electrocardiogram (ECG) and QTc-interval monitoring should be performed. The primary end point was improvement of the appropriateness of ECGs and QTc-interval monitoring of at-risk psychiatric inpatients at Barnabas Health Behavioral Health Center (BHBH) and Monmouth Medical Center (MMC) following implementation of a standardized monitoring protocol. Read More

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http://dx.doi.org/10.9740/mhc.2019.03.082DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398356PMC
March 2019
1 Read

Electrophysiological and Pharmacological Characterization of Human Inwardly Rectifying K2.1 Channels on an Automated Patch-Clamp Platform.

Assay Drug Dev Technol 2019 Apr 5;17(3):89-99. Epub 2019 Mar 5.

1 Integrated Drug Discovery, High-Content Biology, Sanofi Research and Development, Vitry-sur-Seine, France.

Inwardly rectifying I potassium currents of the heart control the resting membrane potential of ventricular cardiomyocytes during diastole and contribute to their repolarization after each action potential. Mutations in the gene encoding K2.1 channels, which primarily conduct ventricular I, are associated with inheritable forms of arrhythmias and sudden cardiac death. Read More

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http://dx.doi.org/10.1089/adt.2018.882DOI Listing
April 2019
3 Reads

The influence of hERG1a and hERG1b isoforms on drug safety screening in iPSC-CMs.

Prog Biophys Mol Biol 2019 Feb 27. Epub 2019 Feb 27.

Department of Medical Physiology, Division Heart & Lungs, University Medical Center Utrecht, the Netherlands. Electronic address:

The human Ether-à-go-go Related Gene (hERG) encodes the pore forming subunit of the channel that conducts the rapid delayed rectifier potassium current I. I drives repolarization in the heart and when I is dysfunctional, cardiac repolarization delays, the QT interval on the electrocardiogram (ECG) prolongs and the risk of developing lethal arrhythmias such as Torsade de Pointes (TdP) increases. TdP risk is incorporated in drug safety screening for cardiotoxicity where hERG is the main target since the I channels appear highly sensitive to blockage. Read More

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http://dx.doi.org/10.1016/j.pbiomolbio.2019.02.003DOI Listing
February 2019
2 Reads

Probable Hypocalcemia Induced Ventricular Fibrillation and Torsades de Pointes following Blood Product Administration.

Cureus 2018 Dec 21;10(12):e3765. Epub 2018 Dec 21.

Cardiology, Hartford Hospital, Hartford, USA.

A 35-year-old male underwent open-heart surgery and required multiple blood product transfusions. Citrate, a preservative in blood products, caused serum ionized calcium chelation leading to hypocalcemia, a prolonged corrected QT (QTc) interval, and separate episodes of ventricular fibrillation and torsades de pointes (TdP). This case highlights an uncommon complication of blood product transfusion-induced hypocalcemia with precipitant arrhythmia. Read More

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https://www.cureus.com/articles/15403-probable-hypocalcemia-
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http://dx.doi.org/10.7759/cureus.3765DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389027PMC
December 2018
8 Reads

Intracellular Mechanism of Rosuvastatin-Induced Decrease in Mature hERG Protein Expression on Membrane.

Mol Pharm 2019 Apr 20;16(4):1477-1488. Epub 2019 Mar 20.

Department of Pharmacology, College of Pharmacy , Harbin Medical University , Harbin , Heilongjiang 150081 , P. R. China.

The hERG potassium channel (IKr) encoded by human ether-a-go-go-related gene plays an important role in cardiac repolarization. Decreased IKr may lead to long QT syndrome, which subsequently causes torsade de pointes and sudden cardiac death. Previous studies have shown that statins inhibit IKr and are more potent in inhibiting hERG currents when combined with other drugs. Read More

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http://dx.doi.org/10.1021/acs.molpharmaceut.8b01102DOI Listing
April 2019
2 Reads

Loperamide associated torsades de pointes, in the setting of complete heart block at marginally supratherapeutic dosing (20mg/day).

Clin Toxicol (Phila) 2019 Feb 19:1-2. Epub 2019 Feb 19.

b Department of Emergency Medicine , University of California San Francisco , San Francisco , CA , USA.

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http://dx.doi.org/10.1080/15563650.2019.1578369DOI Listing
February 2019
3 Reads

Proarrhythmic proclivity of left-stellate ganglion stimulation in a canine model of drug-induced long-QT syndrome type 1.

Int J Cardiol 2019 Jan 31. Epub 2019 Jan 31.

Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands. Electronic address:

Background: Left-stellate ganglion stimulation (LSGS) can modify regional dispersion of ventricular refractoriness, promote triggered activity, and reduce the threshold for ventricular fibrillation (VF). Sympathetic hyperactivity precipitates torsades de pointes (TdP) and VF in susceptible patients with long-QT syndrome type 1 (LQT1). We investigated the electromechanical effects of LSGS in a canine model of drug-induced LQT1, gaining novel arrhythmogenic insights. Read More

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http://dx.doi.org/10.1016/j.ijcard.2019.01.098DOI Listing
January 2019
1 Read

Assessment of the risk of QT-interval prolongation associated with potential drug-drug interactions in patients admitted to Intensive Care Units.

Saudi Pharm J 2019 Feb 10;27(2):229-234. Epub 2018 Nov 10.

Department of Pharmacy, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.

Objectives: To evaluate the relationship between drug interactions and QT-interval prolongation in patients admitted to a general intensive care unit (ICU).

Methods: This study was approved by the Institutional Review Board and written informed consent was obtained from all patients. From May 2015 to July 2016, all patients over 18 years-old admitted to the ICU for more than 24 h and in whom the QT-interval on the ECG could be read were prospectively included in this observational, cross-sectional study. Read More

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http://dx.doi.org/10.1016/j.jsps.2018.11.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6362170PMC
February 2019
1 Read

QT-prolonging agents with risk of torsades de pointes.

Australas Psychiatry 2019 02;27(1):92

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http://dx.doi.org/10.1177/1039856218794875DOI Listing
February 2019
2 Reads

Navigating the Minefield of QTc Interval-Prolonging Therapy in Nursing Facility Residents.

J Am Geriatr Soc 2019 Feb 12. Epub 2019 Feb 12.

College of Pharmacy, Purdue University, School of Medicine, Indiana University, Indianapolis, Indiana.

Background: The exponential increase in the number of medications associated with clinically important prolongation of the heart rate-corrected QT interval (QTc) places older adults at increased risk of arrhythmias including life-threatening torsade de pointes (TdP) and sudden death. Risk factors, other than age older than 65 years and female sex, include multiple concurrent drugs that prolong QTc and a variety of underlying predisposing conditions. Although electronic medical records and pharmacy dispensing systems can alert clinicians to the risk of QTc-prolonging therapy, more than 95% of safety alerts are overridden, and many systems have deactivated QTc drug interaction alerts. Read More

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http://doi.wiley.com/10.1111/jgs.15810
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http://dx.doi.org/10.1111/jgs.15810DOI Listing
February 2019
7 Reads

Rescue Sedation When Treating Acute Agitation in the Emergency Department With Intramuscular Antipsychotics.

J Emerg Med 2019 Feb 8. Epub 2019 Feb 8.

Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota.

Background: Rapid treatment of agitation in the emergency department (ED) is critical to avoid injury to patients and providers. Treatment with intramuscular antipsychotics is often utilized, but there is a paucity of comparative effectiveness evidence available.

Objective: The purpose of this investigation was to compare the effectiveness of droperidol, olanzapine, and haloperidol for treating agitation in the ED. Read More

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http://dx.doi.org/10.1016/j.jemermed.2018.12.036DOI Listing
February 2019
8 Reads

Effect of beta-blockade on quantitative microvolt T-wave alternans in 24-hour continuous 12-lead ECG recordings in patients with long QT syndrome.

Ann Noninvasive Electrocardiol 2019 Feb 6:e12640. Epub 2019 Feb 6.

Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Background: The aim of study was to investigate effects of beta-blockade on microvolt T-wave alternans (TWA), a precursor of lethal arrhythmia, in patients with long QT syndrome (LQTS).

Methods: Eleven consecutive LQTS patients, types 1 (n = 6), 3 (n = 2), and "non-1, non-2, non-3" (n = 3) were enrolled. All patients underwent 24-hr continuous 12-lead ECG monitoring before and after initiation of beta-blockade therapy. Read More

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http://dx.doi.org/10.1111/anec.12640DOI Listing
February 2019
2 Reads

Funny Lumps, Flaming Pheo, and a Broken Heart: A Rare Case of Pheochromocytoma.

Cureus 2018 Nov 28;10(11):e3646. Epub 2018 Nov 28.

Radiology, Florida Hospital-Orlando, Orlando, USA.

Pheochromocytoma is the underlying etiology in 0.1% of hypertensive cases. However, it may be present in up to 5. Read More

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http://dx.doi.org/10.7759/cureus.3646DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351109PMC
November 2018
3 Reads

Measurement of J-Tc along with QT-Interval Prolongation May Increase the Assay Sensitivity and Specificity for Predicting the Onset of Drug-Induced Torsade de Pointes: Experimental Evidences Based on Proarrhythmia Model Animals.

Cardiovasc Toxicol 2019 Feb 2. Epub 2019 Feb 2.

Department of Pharmacology, Toho University Graduate School of Medicine, 5-21-16 Omori-nishi, Ota-ku, Tokyo, 143-8540, Japan.

dl-Sotalol which can block both K channel and ß-adrenoceptor has been shown to prolong the J-Tc of electrocardiogram in beagle dogs but tended to shorten it in microminipigs, although the drug prolonged the QT interval in both animals under physiologically maintained experimental condition. In order to estimate how the changes in the J-Tc in the normal hearts would be reflected in the pathologic hearts, we compared proarrhythmic effects of dl-sotalol by using proarrhythmia models of beagle dogs and microminipigs, of which atrioventricular node had been ablated > 2 months and 8-9 weeks before, respectively (n = 4 for each species). dl-Sotalol in an oral dose of 10 mg/kg induced torsade de pointes in three out of four beagle dogs, which degenerated into ventricular fibrillation. Read More

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http://dx.doi.org/10.1007/s12012-019-09506-zDOI Listing
February 2019
7 Reads

Safety of rapid switching from amiodarone to dofetilide in atrial fibrillation patients with an implantable cardioverter-defibrillator.

Heart Rhythm 2019 Jan 30. Epub 2019 Jan 30.

Kansas City Heart Rhythm Institute & Research Foundation, Overland Park, Kansas. Electronic address:

Background: Dofetilide is a class III antiarrhythmic drug commonly used for treatment of atrial fibrillation. Drug guidelines mandate a 3-month waiting period before initiating dofetilide after amiodarone use. Whether patients with an implantable cardioverter-defibrillator (ICD) can be rapidly switched from amiodarone to dofetilide is not known. Read More

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http://dx.doi.org/10.1016/j.hrthm.2019.01.028DOI Listing
January 2019
11 Reads
5.076 Impact Factor

Twenty-Four-Hour Measures of Heart Rate-Corrected QT Interval, Peak-to-End of the T-Wave, and Peak-to-End of the T-Wave/Corrected QT Interval Ratio During Antipsychotic Treatment.

J Clin Psychopharmacol 2019 Mar/Apr;39(2):100-107

Beasley Pharmaceutical and Biotechnology Consulting, LLC, Indianapolis, IN.

Purpose/background: Prolonged ventricular repolarization, measured by heart rate-corrected QT interval (QTc) prolongation, might be a biomarker for risk of torsade de pointes (TdP) and sudden cardiac death. However, the predictive value of QTc has been challenged, and a component of QTc, peak-to-end of the T-wave (Tpe), and a high Tpe/QT ratio might be superior biomarkers because they better reflect increased transmural dispersion of ventricular myocyte repolarization, which can lead to TDP. The purpose of this pilot study was to provide the first measurements of heart rate, QTc, Tpe, Tpe/QTc, and their variability over 24 hours in medication-free patients with schizophrenia, during treatment with ziprasidone or other antipsychotic drugs, and healthy controls. Read More

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http://dx.doi.org/10.1097/JCP.0000000000001003DOI Listing
March 2019
3 Reads

Cardiac toxicity of combined vemurafenib and cobimetinib administration
.

Int J Clin Pharmacol Ther 2019 May;57(5):259-263

Vemurafenib and cobimetinib are extremely effective in treating V600E-mutated metastatic melanoma, but their use is associated with toxic cardiac effects. Vemurafenib-induced prolonged QTc interval may be associated with ventricular fibrillation and sudden cardiac death. Cobimetinib-induced myocardial damage may lead to severely reduced heart function and lethal heart failure. Read More

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http://dx.doi.org/10.5414/CP203379DOI Listing
May 2019
2 Reads

Cardiac arrhythmia considerations of hormone cancer therapies.

Cardiovasc Res 2019 Apr;115(5):878-894

Department of Medicine and Clinical Pharmacology, Cardio-Oncology Program, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN, USA.

Breast and prostate cancers are among the most prevalent cancers worldwide. Oestradiol and progesterone are major drivers for breast cancer proliferation, and androgens for prostate cancer. Endocrine therapies are drugs that interfere with hormone-activated pathways to slow cancer progression. Read More

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https://academic.oup.com/cardiovascres/advance-article/doi/1
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http://dx.doi.org/10.1093/cvr/cvz020DOI Listing
April 2019
20 Reads

Amiodarone-induced life-threatening torsade de pointes in an end-stage lung cancer patient receiving gefitinib.

Oxf Med Case Reports 2019 Jan 24;2019(1):omy122. Epub 2019 Jan 24.

Department of Cardiovascular Medicine, First Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, China.

The risk factors of acquired long QT syndrome (aLQTS) are sometimes overlooked in clinics. Drugs, hypokalemia, age and female sex are well-known risk factors of QT prolongation-dependent torsade de pointes (TdP), which explains the high incidence of sudden cardiac death in LQT patients. Here, we report a case of an elderly female patient with lung cancer who was in poor condition, for whom amiodarone was mistakenly prescribed to rectify premature ventricular contractions. Read More

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http://dx.doi.org/10.1093/omcr/omy122DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345081PMC
January 2019
2 Reads

Evaluation of the effects on the QT-interval of 4 artemisinin-based combination therapies with a correction-free and heart rate-free method.

Sci Rep 2019 Jan 29;9(1):883. Epub 2019 Jan 29.

Cardiabase, 84 avenue du XXème Corps, 54000, Nancy, France.

Several antimalarial drugs are known to prolong ventricular repolarization as evidenced by QT/QTc interval prolongation. This can lead to Torsades de Pointes, a potentially lethal ventricular arrhythmia. Whether this is the case with artemisinin-based combination therapies (ACTs) remains uncertain. Read More

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http://dx.doi.org/10.1038/s41598-018-37113-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351684PMC
January 2019
4 Reads
5.078 Impact Factor

Effects of Dihydroartemisinin-Piperaquine Phosphate and Artemether-Lumefantrine on QTc Interval Prolongation.

Sci Rep 2019 Jan 28;9(1):777. Epub 2019 Jan 28.

Sigma-tau Industrie Farmaceutiche Riunite S.p.A., Pomezia, (Rome), Italy.

QT/QTc interval prolongation reflects delayed cardiac repolarization which can lead to Torsade de Pointes and sudden death. Many antimalarial drugs prolong QT/QTc interval. However, due to confounding factors in patients with malaria, the precise extent of this effect has been found to be highly variable among studies. Read More

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http://dx.doi.org/10.1038/s41598-018-37112-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6349839PMC
January 2019
3 Reads
5.078 Impact Factor

A current understanding of drug-induced QT prolongation and its implications for anticancer therapy.

Authors:
Dan M Roden

Cardiovasc Res 2019 Apr;115(5):895-903

Department of Medicine, Vanderbilt University Medical Center, 2215B Garland Avenue, Room 1285B, Nashville, TN, USA.

The QT interval, a global index of ventricular repolarization, varies among individuals and is influenced by diverse physiologic and pathophysiologic stimuli such as gender, age, heart rate, electrolyte concentrations, concomitant cardiac disease, and other diseases such as diabetes. Many drugs produce a small but reproducible effect on QT interval but in rare instances this is exaggerated and marked QT prolongation can provoke the polymorphic ventricular tachycardia 'torsades de pointes', which can cause syncope or sudden cardiac death. The generally accepted common mechanism whereby drugs prolong QT is block of a key repolarizing potassium current in heart, IKr, generated by expression of KCNH2, also known as HERG. Read More

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http://dx.doi.org/10.1093/cvr/cvz013DOI Listing
April 2019
3 Reads

Compounds commonly used in equine medicine inhibits the voltage-gated potassium channel K11.1.

Res Vet Sci 2019 Apr 8;123:239-246. Epub 2019 Jan 8.

Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark.

Background: The voltage-gated K-channel K11.1 has a central role in cardiac repolarization. Blockage of K11. Read More

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http://dx.doi.org/10.1016/j.rvsc.2019.01.009DOI Listing
April 2019
9 Reads

Lesson of the month 1: Prolonged QT syndrome due to donepezil: a reversible cause of falls?

Clin Med (Lond) 2019 Jan;19(1):80-81

Airedale General Hospital, Keighley, UK.

Prolonged QT syndrome precipitates cardiac arrhythmias such as torsades de pointes (TdP) resulting in cardiogenic syncope or sudden death. We report a case of prolonged QT syndrome caused by donepezil which resulted in a fall and hip fracture. In this case female sex, advanced age and diuretic use may have increased the risk of recurrent syncope and potential underlying TdP. Read More

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http://dx.doi.org/10.7861/clinmedicine.19-1-80DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399646PMC
January 2019
3 Reads

A literature-based algorithm for the assessment, management, and monitoring of drug-induced QTc prolongation in the psychiatric population.

Authors:
M Zolezzi L Cheung

Neuropsychiatr Dis Treat 2019 24;15:105-114. Epub 2018 Dec 24.

Pharmacy Department, Grey Nuns Community Hospital, Edmonton, AB, Canada.

Background: Certain psychotropics and a number of other medications used to treat medical conditions in psychiatric patients can increase the risk of prolonging the corrected QT (QTc) interval on the electrocardiogram, which puts patients at risk of life-threatening ventricular arrhythmias such as torsades de pointes. Pharmacists are often consulted about medications which are known to prolong the QTc interval. Although this information is often accessible, advising how to identify, assess, manage, and refer psychiatric patients at risk for drug-induced QTc prolongation is more challenging. Read More

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http://dx.doi.org/10.2147/NDT.S186474DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6309020PMC
December 2018
2 Reads

Torsades de Pointes in Intravenous Drug Abuse-Associated Infective Endocarditis.

Heart Surg Forum 2018 12 19;21(6):E507-E512. Epub 2018 Dec 19.

Department of Surgery, Summa Akron City Hospital, Akron, OH, USA.

Intravenous drug abuse rates in the United States have increased exponentially in recent years. Ohio is one of 5 states with the highest age-adjusted drug overdose death rates, with drug overdose causing 39.1 of every 100,000 deaths. Read More

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http://dx.doi.org/10.1532/hsf.2167DOI Listing
December 2018
5 Reads

Idiopathic short-coupled ventricular tachyarrhythmias: Systematic review and validation of electrocardiographic indices.

Egypt Heart J 2018 Dec 22;70(4):301-306. Epub 2018 Jun 22.

Prince Sultan Cardiac Centre, Military hospital, Riyadh, Saudi Arabia.

Introduction: Idiopathic short-coupled ventricular tachyarrhythmias make up a considerable proportion of ventricular tachyarrhythmias in structurally normal hearts and are the cause of 5-10% of unexpected sudden cardiac deaths. There is disparity in the literature regarding their description and a lack of formal diagnostic criteria to define them.

Objective: To validate ECG indices for the diagnosis of these ventricular tachyarrythmias and to subsequently unify their differing descriptions in the literature under a new terminology: . Read More

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http://dx.doi.org/10.1016/j.ehj.2018.06.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6303349PMC
December 2018
3 Reads

Simultaneous Occurrence of Dysrhythmia and Seizure as a Diagnostic Difficulty; a Case Report.

Emerg (Tehran) 2018 8;6(1):e49. Epub 2018 Aug 8.

Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran.

Torsades de pointes (TdP) is a rare but hazardous ventricular dysrhythmia caused by an increase in the QT interval of the heart rhythm and is categorized into congenital or acquired types. Signs and symptoms of TdP include syncope, seizure, ventricular fibrillation, and even sudden death. According to statistics, among these symptoms, syncope and the seizure can be considered as signs that make the TdP diagnosis difficult. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289149PMC
August 2018
9 Reads