4,785 results match your criteria Torsade de Pointes


Cardiac Arrest Risk During Acute Infections: Systemic Inflammation Directly Prolongs QTc Interval via Cytokine-mediated Effects on Potassium Channel Expression.

Circ Arrhythm Electrophysiol 2020 Jul 13. Epub 2020 Jul 13.

Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.

- During acute infections the risk of malignant ventricular arrhythmias (VA) is increased, partly because of a higher propensity to develop QTc prolongation. Although it is generally believed that QTc changes almost exclusively result from concomitant treatment with QT-prolonging antimicrobials, direct effects of inflammatory cytokines on ventricular repolarization are increasingly recognized. We hypothesized that systemic inflammation can significantly prolong QTc during acute infections, via cytokine-mediated changes in K-channels expression. Read More

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http://dx.doi.org/10.1161/CIRCEP.120.008627DOI Listing

QT Interval Control to Prevent Torsades de Pointes during Use of Hydroxychloroquine and/or Azithromycin in Patients with COVID-19.

Arq Bras Cardiol 2020 06 3;114(6):1061-1066. Epub 2020 Jul 3.

Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.

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http://dx.doi.org/10.36660/abc.20200389DOI Listing

Clinical guidance for navigating the QTc-prolonging and arrhythmogenic potential of pharmacotherapy during the COVID-19 pandemic.

Ir J Med Sci 2020 Jul 6. Epub 2020 Jul 6.

Department of Cardiology, Beaumont Hospital, Dublin, Ireland.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for coronavirus disease 19 (COVID-19), has rapidly spread since December 2019 to become the focus of healthcare systems worldwide. Its highly contagious nature and significant mortality has led to its prioritization as a public health issue. The race to prevent and treat this disease has led to "off-label" prescribing of medications such as hydroxychloroquine, azithromycin, and Kaletra (lopinavir/ritonavir). Read More

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http://dx.doi.org/10.1007/s11845-020-02291-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335663PMC

Serious Adverse Events Associated With Hydroxychloroquine Amidst COVID-19 Pandemic: Case Series and Literature Review.

Cureus 2020 Jun 2;12(6):e8415. Epub 2020 Jun 2.

Cardiology, Ocala Regional Medical Center, Ocala, USA.

COVID-19 represents a global health crisis. Several studies are evaluating potential therapies including hydroxychloroquine (HCQ) which is given to patients based on limited observational evidence. However, it can cause serious adverse events. Read More

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http://dx.doi.org/10.7759/cureus.8415DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7331778PMC

Treatment with Hydroxychloroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19.

Int J Infect Dis 2020 Jul 2. Epub 2020 Jul 2.

Infectious Diseases, Henry Ford Hospital, Detroit, MI, United States; Wayne State University School of Medicine, Detroit, MI, United States. Electronic address:

Significance: The United States is in an acceleration phase of the COVID-19 pandemic. Currently there is no known effective therapy or vaccine for treatment of SARS-CoV-2, highlighting urgency around identifying effective therapies.

Objective: The purpose of this study was to evaluate the role of hydroxychloroquine therapy alone and in combination with azithromycin in hospitalized patients positive for COVID-19. Read More

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http://dx.doi.org/10.1016/j.ijid.2020.06.099DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330574PMC

Prophylactic (hydroxy)chloroquine in COVID-19: potential relevance for cardiac arrhythmia risk.

Heart Rhythm 2020 Jul 2. Epub 2020 Jul 2.

Amsterdam UMC, University of Amsterdam, Heart Center; Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands; European Cardiac Arrhythmia Genetics Focus Group (ECGen) of the European Heart Rhythm Association (EHRA). Electronic address:

(Hydroxy)chloroquine ((H)CQ) is being investigated as treatment for COVID-19, but studies have so far demonstrated either no or a small benefit. However, these studies have been mostly performed in patients admitted to hospital and hence likely already (severely) affected. Another suggested approach employs prophylactic (H)CQ treatment aimed at preventing either SARS-CoV-2 infection or development of disease. Read More

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http://dx.doi.org/10.1016/j.hrthm.2020.07.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7332460PMC

Which QTc correction formulae (Bazett, Framingham, or Fridericia) to use for Hydroxychloroquine induced QTc prolongation?

Indian Pacing Electrophysiol J 2020 Jul 1. Epub 2020 Jul 1.

Department of Cardiology, VMMC and Safdarjung Hospital, New Delhi, India. Electronic address:

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http://dx.doi.org/10.1016/j.ipej.2020.06.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327452PMC

Concealed congenital long QT syndrome during velopharyngeal dysfunction correction: a case report.

J Dent Anesth Pain Med 2020 Jun 24;20(3):165-171. Epub 2020 Jun 24.

Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Busan, Korea.

The congenital long QT syndrome (LQTS) is an inherited cardiac disorder characterized by increased QT intervals and a tendency to experience ventricular tachycardia, which can cause fainting, heart failure, or sudden death. A 4-year-old female patient undergoing velopharyngeal correction surgery under general anesthesia suddenly developed Torsades de pointes. Although the patient spontaneously resolved to sinus rhythm without treatment, subsequent QT prolongation persisted. Read More

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http://dx.doi.org/10.17245/jdapm.2020.20.3.165DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7321742PMC

Acquired Long QT Syndrome after Acute Myocardial Infarction: A Rare but Potentially Fatal Entity.

Tex Heart Inst J 2020 Apr;47(2):163-164

Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, California 90025.

Acquired long QT syndrome is typically caused by medications, electrolyte disturbances, bradycardia, or catastrophic central nervous system events. We report a case of myocardial infarction-related acquired long QT syndrome in a 58-year-old woman that had no clear cause and progressed to torsades de pointes requiring treatment with isoproterenol and magnesium. Despite negative results of DNA testing against a known panel of genetic mutations and polymorphisms associated with long QT syndrome, the patient's family history of fatal cardiac disease suggests a predisposing genetic component. Read More

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http://dx.doi.org/10.14503/THIJ-18-6872DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328093PMC

Immunosuppressant associated torsades de pointes after acute heart rejection in an 8-year-old boy.

Cardiol Young 2020 Jun 30:1-2. Epub 2020 Jun 30.

Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan.

Torsades de pointes is a kind of life-threatening ventricular tachyarrhythmia. We report a case of torsades de pointes in an 8-year-old boy with acute rejection after orthotopic heart transplantation. The causes of torsades de pointes could be either congenital or acquired. Read More

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http://dx.doi.org/10.1017/S1047951120001602DOI Listing

Idiopathic Ventricular Fibrillation: Diagnosis, Ablation of Triggers, Gaps in Knowledge, and Future Directions.

J Innov Card Rhythm Manag 2020 Jun 15;11(6):4135-4146. Epub 2020 Jun 15.

Heart and Vascular Center, MetroHealth Campus of Case Western Reserve University, Cleveland, OH, USA.

Idiopathic ventricular fibrillation (IVF) is a diagnosis of exclusion made when no underlying cause is identified in a cardiac arrest survivor. Although the frequency of this diagnosis has declined over time due to advances in diagnostic techniques, it remains a substantial cause of sudden cardiac arrest. Further, IVF tends to recur. Read More

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http://dx.doi.org/10.19102/icrm.2020.110604DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7313628PMC

Enhanced Response to Drug-Induced QT Interval Lengthening in Patients with Heart Failure with Preserved Ejection Fraction.

J Card Fail 2020 Jun 24. Epub 2020 Jun 24.

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

Background: Patients with heart failure (HF) with reduced ejection fraction demonstrate enhanced response to drug-induced QT interval lengthening and are at increased risk for torsades de pointes. The influence of HF with preserved ejection fraction (HFpEF) on response to drug-induced QT lengthening is unknown.

Methods And Results: We administered intravenous ibutilide 0. Read More

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http://dx.doi.org/10.1016/j.cardfail.2020.06.008DOI Listing

'Social distancing' of the neuronal nitric oxide synthase from its adaptor protein causes arrhythmogenic trigger-substrate interactions in Long QT Syndrome.

Cardiovasc Res 2020 Jun 26. Epub 2020 Jun 26.

Department of Internal Medicine, Section of Cardiovascular Medicine, Yale New Haven Hospital.

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http://dx.doi.org/10.1093/cvr/cvaa179DOI Listing

A case of torsades de pointes induced by the third-generation EGFR-TKI, osimertinib combined with moxifloxacin.

BMC Pulm Med 2020 Jun 24;20(1):181. Epub 2020 Jun 24.

Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.

Background: Torsade de pointes (TdP) is a malignant arrhythmia that can be induced by QT internal prolongation due to a variety of factors. Here we report an elderly patient with advanced non-small cell lung cancer (NSCLC) had sudden TdP during hospitalization, which was caused by multiple factors such as osimertinib, moxifloxacin and patient self-factors.

Case Presentation: An 85-year-old man with advanced NSCLC with brain andbone metastasis was initially treated with gefitinib targeted therapy. Read More

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http://dx.doi.org/10.1186/s12890-020-01217-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7313192PMC

Use of QT Prolonging Medications by Hemodialysis Patients and Individuals Without End-Stage Kidney Disease.

J Am Heart Assoc 2020 Jul 24;9(13):e015969. Epub 2020 Jun 24.

University of North Carolina Kidney Center Division of Nephrology and Hypertension Department of Medicine University of North Carolina School of Medicine Chapel Hill NC.

Background The rate of sudden cardiac death in the hemodialysis population exceeds that of the general population by >20-fold. Hemodialysis patients may be particularly susceptible to sudden cardiac death provoked by drug-induced QT prolongation because of their substantial cardiovascular disease burden, exposure to electrolyte shifts during dialysis, and extensive polypharmacy. However, population-specific data regarding the frequency and patterns of QT prolonging medication use are limited. Read More

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http://dx.doi.org/10.1161/JAHA.120.015969DOI Listing

QT interval prolongation and torsade de pointes induced by left ventricular pacing rescued by His bundle pacing.

HeartRhythm Case Rep 2020 Jun 29;6(6):325-328. Epub 2020 Feb 29.

Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas.

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http://dx.doi.org/10.1016/j.hrcr.2020.02.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7300327PMC

Emerging Concepts and Applied Machine Learning Research in Patients with Drug-Induced Repolarization Disorders.

Stud Health Technol Inform 2020 Jun;270:198-202

Division of Clinical Pharmacology and Toxicology; Medical Direction, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland.

The paper presents a review of current research to develop predictive models for automated detection of drug-induced repolarization disorders and shows a feasibility study for developing machine learning tools trained on massive multimodal datasets of narrative, textual and electrocardiographic records. The goal is to reduce drug-induced long QT and associated complications (Torsades-de-Pointes, sudden cardiac death), by identifying prescription patterns with pro-arrhythmic propensity using a validated electronic application for the detection of adverse drug events with data mining and natural language processing; and to compute individual-based predictive scores in order to further identify clinical conditions, concomitant diseases, or other variables that correlate with higher risk of pro-arrhythmic situations. Read More

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http://dx.doi.org/10.3233/SHTI200150DOI Listing

Cannabinoid-Induced Brugada Syndrome: A Case Report.

Cureus 2020 Jun 14;12(6):e8615. Epub 2020 Jun 14.

Cardiology, Cape Fear Valley Health System, Fayetteville, USA.

Brugada syndrome, also called Pokkuri Death Syndrome, is an autosomal dominant electrophysiological phenomenon that increases the risk of spontaneous ventricular tachyarrhythmia and sudden cardiac death. Due to sodium channel mutations in the cardiac membrane, most commonly SCN5A and SCN10A, the heart can be triggered into a fatal arrhythmia. Brugada syndrome can be triggered by fever, and medications including antiarrhythmics, psychotropics, and recreational drugs like cocaine and marijuana. Read More

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http://dx.doi.org/10.7759/cureus.8615DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7294878PMC

A Pharmacovigilance Study of Hydroxychloroquine Cardiac Safety Profile: Potential Implication in COVID-19 Mitigation.

J Clin Med 2020 Jun 15;9(6). Epub 2020 Jun 15.

Division of Cardiovascular Disease, UAB|The University of Alabama at Birmingham, Birmingham, AL 35294-1913, USA.

In light of the favorable outcomes of few small, non-randomized clinical studies, the Food and Drug Administration (FDA) has issued an Emergency Use Authorization (EUA) to Hydroxychloroquine (HCQ) for hospitalized coronavirus disease 2019 (COVID-19) patients. In fact, subsequent clinical studies with COVID-19 and HCQ have reported limited efficacy and poor clinical benefits. Unfortunately, a robust clinical trial for its effectiveness is not feasible at this emergency. Read More

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http://dx.doi.org/10.3390/jcm9061867DOI Listing

models for evaluating proarrhythmic risk of drugs.

APL Bioeng 2020 Jun 4;4(2):021502. Epub 2020 Jun 4.

Department of Physiology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul 05505, South Korea.

Safety evaluation of drugs requires examination of the risk of generating Torsade de Pointes (TdP) because it can lead to sudden cardiac death. Until recently, the QT interval in the electrocardiogram (ECG) has been used in the evaluation of TdP risk because the QT interval is known to be associated with the development of TdP. Although TdP risk evaluation based on QT interval has been successful in removing drugs with TdP risk from the market, some safe drugs may have also been affected due to the low specificity of QT interval-based evaluation. Read More

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http://dx.doi.org/10.1063/1.5132618DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7274812PMC

Effects of antidepressants on QT interval in people with mental disorders.

Arch Med Sci 2020 29;16(4):727-741. Epub 2020 May 29.

Elsevier, Clinical Solutions, Philadelphia, USA.

Introduction: Drug-induced QT prolongation is associated with higher cardiovascular mortality.

Material And Methods: We conducted a protocol-based comprehensive review of antidepressant-induced QT prolongation in people with mental disorders.

Results: Based on findings from 47 published randomized controlled trials (RCTs), 3 unpublished RCTs, 14 observational studies, 662 case reports of torsades de pointes, and 168 cases of QT prolongation, we conclude that all antidepressants should be used only with licensed doses, and that all patients receiving antidepressants require monitoring of QT prolongation and clinical symptoms of cardiac arrhythmias. Read More

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http://dx.doi.org/10.5114/aoms.2019.86928DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286318PMC

Estimates of population-based incidence of malignant arrhythmias associated with medication use-a narrative review.

Fundam Clin Pharmacol 2020 Jun 15. Epub 2020 Jun 15.

School of Pharmacy, Faculty of Science, University of Waterloo, Room 3006, 10A Victoria St. S., Kitchener, ON, Canada.

Certain medications are reported to be associated with acquired long-QT syndrome (ALQTS), which can degenerate into a potentially severe 'malignant' arrhythmia known as torsades de pointes (TdP). However, population-based estimations of the incidence of medication-associated malignant arrhythmia are limited. The purpose of this article is to review the clinical symptoms, cellular mechanism, categorization, and risk factors of these malignant arrhythmias, as well as illustrate results and methodological limitations of epidemiological literature which have previously estimated population-based incidence of ALQTS and malignant arrhythmia. Read More

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http://dx.doi.org/10.1111/fcp.12578DOI Listing

Walk the Line-The Importance of Well-Informed Interpretation of QT Prolongation.

Ann Pharmacother 2020 Jun 13:1060028020934718. Epub 2020 Jun 13.

University of Kentucky College of Pharmacy, Lexington, KY, USA.

Acute care pharmacists play an integral role in identifying drug-drug interactions that may predispose patients to QT prolongation. Although most pharmacists are equipped with a baseline understanding of drug interactions and the risks of QTc prolongation, few understand the limitations of QTc calculation and interpretation. In this commentary, we put forth the notion that at times health care providers, including pharmacists, place an overemphasis on the QTc interval. Read More

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http://dx.doi.org/10.1177/1060028020934718DOI Listing

Relation between index of cardioelectrophysiological balance and stroke severity in patients with acute ischemic stroke.

Authors:
U Ozturk O Ozturk

Niger J Clin Pract 2020 Jun;23(6):768-774

Department of Cardiology, University of Health Sciences, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey.

Background: The index of cardioelectrophysiological balance (iCEB), measured as QT interval divided by QRS duration, has recently been defined as a new risk marker for arrhythmias. Increased or decreased iCEB is associated with malignant ventricular arrhythmias.

Aim: In this study, we aimed to investigate the relationship between iCEB and stroke severity in patients with acute ischemic stroke. Read More

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http://dx.doi.org/10.4103/njcp.njcp_505_19DOI Listing

[Panic and pandemic: Review of the literature on the links between panic disorder and the SARS-CoV-2 epidemic].

Authors:
H Javelot L Weiner

Encephale 2020 Jun 21;46(3S):S93-S98. Epub 2020 May 21.

Clinique de psychiatrie, CHU de Strasbourg, Strasbourg, France; Laboratoire de psychologie des cognitions, université de Strasbourg, Strasbourg, France.

Although the "panic" word has been abundantly linked to the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic in the press, in the scientific literature very few studies have considered whether the current epidemic could predispose to the onset or the aggravation of panic attacks or panic disorder. Indeed, most studies thus far have focused on the risk of increase and aggravation of other psychiatric disorders as a consequence of the SARS-CoV-2 epidemic, such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and generalized anxiety disorder (GAD). Yet, risk of onset or aggravation of panic disorder, especially the subtype with prominent respiratory symptoms, which is characterized by a fear response conditioning to interoceptive sensations (e. Read More

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http://dx.doi.org/10.1016/j.encep.2020.05.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7241353PMC

In vivo analysis of the effects of intravenously as well as orally administered moxifloxacin on the pharmacokinetic and electrocardiographic variables along with its torsadogenic action in the chronic atrioventricular block cynomolgus monkeys.

J Pharmacol Sci 2020 Aug 28;143(4):272-280. Epub 2020 May 28.

Department of Pharmacology, Toho University Graduate School of Medicine, 5-21-16 Omori-nishi, Ota-ku, Tokyo, 143-8540, Japan; Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo, 143-8540, Japan; Department of Translational Research & Cellular Therapeutics, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo, 143-8540, Japan; Department of Aging Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo, 143-8540, Japan. Electronic address:

We analyzed the effects of intravenously as well as orally administered moxifloxacin on the pharmacokinetic and electrocardiographic variables along with its torsadogenic action using the chronic atrioventricular block cynomolgus monkeys with a cross-over design. Initially, moxifloxacin was intravenously administered in doses of 60 mg/kg/2 h, 60 mg/kg/1 h and 105 mg/kg/1.75 h with an interval of >1 week (n = 3), which provided C of 19. Read More

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http://dx.doi.org/10.1016/j.jphs.2020.05.006DOI Listing

Risperidone alone did not induce torsade de pointes: Experimental evidence from the chronic atrioventricular block model dogs.

J Pharmacol Sci 2020 Aug 27;143(4):330-332. Epub 2020 May 27.

Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo, 143-8540, Japan; Department of Translational Research & Cellular Therapeutics, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo, 143-8540, Japan; Department of Aging Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo, 143-8540, Japan. Electronic address:

We assessed torsadogenic action of risperidone, which can potently inhibit I as well as α-adrenoceptor. A toxic dose of 3 mg/kg of risperidone was intravenously administered over 10 min to chronic atrioventricular block dogs without anesthesia with monitoring Holter electrocardiogram (n = 4). Risperidone increased atrial/ventricular rate for 1-12 h/1-6 h and prolonged QTcF at 6 h after its administration, whereas it did not increase short-term variability of repolarization or induced torsade de pointes. Read More

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http://dx.doi.org/10.1016/j.jphs.2020.05.008DOI Listing

COVID-19 and cardiac arrhythmias: a global perspective on arrhythmia characteristics and management strategies.

J Interv Card Electrophysiol 2020 Jun 3. Epub 2020 Jun 3.

Cooper University Hospital, Camden, NJ, USA.

Background: Cardiovascular and arrhythmic events have been reported in hospitalized COVID-19 patients. However, arrhythmia manifestations and treatment strategies used in these patients have not been well-described. We sought to better understand the cardiac arrhythmic manifestations and treatment strategies in hospitalized COVID-19 patients through a worldwide cross-sectional survey. Read More

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http://dx.doi.org/10.1007/s10840-020-00789-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268965PMC

Effectiveness of Interferon Beta 1a, compared to Interferon Beta 1b and the usual therapeutic regimen to treat adults with moderate to severe COVID-19: structured summary of a study protocol for a randomized controlled trial.

Trials 2020 Jun 3;21(1):473. Epub 2020 Jun 3.

Department of Infectious Diseases, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Objectives: We will investigate the effectiveness of Interferon Beta 1a, compared to Interferon Beta 1b and the usual therapeutic regimen in COVID-19 in patients that have tested positive and are moderately to severely ill.

Trial Design: This is a single center, open label, randomized, controlled, parallel group, clinical trial that will be conducted at Loghman Hakim Medical Education Center in conjunction with Shahid Beheshti University of Medical Sciences.

Participants: Sixty COVID-19 confirmed cases (using the RT-PCR test) will be enrolled in the trial between April 9 to April 14 2020. Read More

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http://dx.doi.org/10.1186/s13063-020-04382-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268172PMC

Prevalence of QTc interval prolongation and its associated risk factors among psychiatric patients: a prospective observational study.

BMC Psychiatry 2020 Jun 3;20(1):277. Epub 2020 Jun 3.

Department of Pharmacy, University of Peshawar, Peshawar, Khyber Pakhtunkhwa, Pakistan.

Background: QT interval prolongation is a growing concern worldwide, posing psychiatric patients to life-threatening fatal arrhythmias i.e., torsade de pointes. Read More

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http://dx.doi.org/10.1186/s12888-020-02687-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268705PMC

The QT interval in patients with COVID-19 treated with hydroxychloroquine and azithromycin.

Nat Med 2020 06;26(6):808-809

Leon H. Charney Division of Cardiology, Cardiac Electrophysiology, NYU Langone Health, New York University School of Medicine, New York, NY, USA.

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http://dx.doi.org/10.1038/s41591-020-0888-2DOI Listing

Incidence and determinants of QT interval prolongation in COVID-19 patients treated with hydroxychloroquine and azithromycin.

J Cardiovasc Electrophysiol 2020 Jun 2. Epub 2020 Jun 2.

Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut.

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http://dx.doi.org/10.1111/jce.14594DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7300464PMC

Androgen Deprivation Therapy for Prostatic Cancer in Patients With Torsades de Pointes.

Front Pharmacol 2020 13;11:684. Epub 2020 May 13.

Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.

Background: Men normally have shorter heart rate-corrected QT interval (QTc) than women, at least in part due to accelerating effects of testosterone on ventricular repolarization. Accumulating data suggest that androgen-deprivation therapy (ADT) used for the treatment of prostatic cancer, may increase Torsades de Pointes (TdP) risk by prolonging QTc. However, the evidence for such an association is currently limited to few case reports, in most cases deriving from the analysis of uncontrolled sources such as pharmacovigilance databases. Read More

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http://dx.doi.org/10.3389/fphar.2020.00684DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7239032PMC

Biomarkers of pre-existing risk of Torsade de Pointes under Sotalol treatment.

J Electrocardiol 2020 May - Jun;60:177-183. Epub 2020 May 4.

Instituto de Ingeniería Biomédica, UBA, Paseo Colón 850 (C1063ACV), Buenos Aires, Argentina; Instituto Argentino de Matemática 'Alberto P. Calderón', CONICET, Saavedra 15 (C1083ACA), Buenos Aires, Argentina.

Introduction: Antiarrhythmic drugs therapies are currently going through a turning point. The high risk that exists during the treatments has led to an ongoing search for new non-invasive toxicity risk biomarkers.

Methods: We propose the use of spatial biomarkers obtained through the quaternion algebra, evaluating the dynamics of the cardiac electrical vector in a non-invasive way in order to detect abnormal changes in ventricular heterogeneity. Read More

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http://dx.doi.org/10.1016/j.jelectrocard.2020.04.011DOI Listing

Experience With Hydroxychloroquine and Azithromycin in the Coronavirus Disease 2019 Pandemic: Implications for QT Interval Monitoring.

J Am Heart Assoc 2020 06 28;9(12):e017144. Epub 2020 May 28.

The Smidt Heart Institute, Cedars-Sinai Health System Los Angeles CA.

Background Despite a lack of clinical evidence, hydroxychloroquine and azithromycin are being administered widely to patients with verified or suspected coronavirus disease 2019 (COVID-19). Both drugs may increase risk of lethal arrhythmias associated with QT interval prolongation. Methods and Results We analyzed a case series of COVID-19-positive/suspected patients admitted between February 1, 2020, and April 4, 2020, who were treated with azithromycin, hydroxychloroquine, or a combination of both drugs. Read More

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http://dx.doi.org/10.1161/JAHA.120.017144DOI Listing

A Unique Interplay of Multiple Predisposing Factors Culminating in a Catastrophic QT Prolongation.

Cureus 2020 Apr 21;12(4):e7757. Epub 2020 Apr 21.

Cardiology, Electrophysiology, State University of New York (SUNY) Upstate Medical University, Syracuse, USA.

Implantable cardioverter-defibrillators (ICDs) are used in patients without a reversible cause for long QT syndrome (LQTS) and secondary prevention in patients with LQTS-associated sudden cardiac arrest. We present a female patient with multiple reversible factors for QT prolongation, including the use of antidepressants, antidiarrheals, antiemetics, and antihistamines; chronic malabsorption from bariatric surgery; probable Gitelman syndrome and urinary losses of electrolytes, causing QT prolongation which leads to polymorphic ventricular tachycardia and a successfully resuscitated cardiac arrest. Our patient also had history suggestive of probable congenital LQTS with multiple childhood syncopal episodes and a history of seizures in first-degree relatives, further justifying the placement of an ICD. Read More

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http://dx.doi.org/10.7759/cureus.7757DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7243073PMC

Risk of QTc Prolongation Among Cancer Patients Treated with Tyrosine Kinase Inhibitors.

Int J Cancer 2020 May 25. Epub 2020 May 25.

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.

QTc interval prolongation can lead to life-threatening complications such as torsade de pointes (TdP), ventricular tachycardia (VT), and sudden cardiac death (SCD). It can occur with tyrosine kinase inhibitors (TKIs) but comparative real-world analyses on the incidence and complication rates are scarce. We retrospectively reviewed all cancer patients treated with TKI at Mayo Clinic between 01/2005 and 12/2018 and had at least two ECGs (before and after TKI). Read More

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http://dx.doi.org/10.1002/ijc.33119DOI Listing

QTc monitoring in adults with medical and psychiatric comorbidities: Expert consensus from the Association of Medicine and Psychiatry.

J Psychosom Res 2020 May 11;135:110138. Epub 2020 May 11.

Departments of Psychiatry, Epidemiology, and Internal Medicine, University of Iowa, Iowa City, IA, United States of America.

Objective: Several psychiatric medications have the potential to prolong the QTc interval and subsequently increase the risk for ventricular arrhythmias such as torsades de pointes (TdP). There is limited guidance for clinicians to balance the risks and benefits of treatments.

Methods: After a review of the existing literature, clinical-educators from the Association of Medicine and Psychiatry developed expert consensus guidelines for ECG monitoring of the QTc interval for patients with medical and psychiatric comorbidities who are prescribed medications with the potential to prolong the QTc interval. Read More

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http://dx.doi.org/10.1016/j.jpsychores.2020.110138DOI Listing

QT prolongation, torsades de pointes, and sudden death with short courses of chloroquine or hydroxychloroquine as used in COVID-19: A systematic review.

Heart Rhythm 2020 May 11. Epub 2020 May 11.

Dalhousie University, Faculty of Medicine, Halifax, Nova Scotia, Canada.

Chloroquine and hydroxychloroquine are now being widely used for treatment of COVID-19. Both medications prolong the QT interval and accordingly may put patients at increased risk for torsades de pointes and sudden death. Published guidance documents vary in their recommendations for monitoring and managing these potential adverse effects. Read More

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http://dx.doi.org/10.1016/j.hrthm.2020.05.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211688PMC

Cardiac Arrhythmias in COVID-19 Infection.

Circ Arrhythm Electrophysiol 2020 06 20;13(6):e008719. Epub 2020 May 20.

Division of Cardiology, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY (S.M.K., E.C., A.N., L.S.R., A.G., A.B.B., H.G., E.Y.W.).

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http://dx.doi.org/10.1161/CIRCEP.120.008719DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7299099PMC

COVID-19 Management and Arrhythmia: Risks and Challenges for Clinicians Treating Patients Affected by SARS-CoV-2.

Front Cardiovasc Med 2020 5;7:85. Epub 2020 May 5.

School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, United Kingdom.

The COVID-19 pandemic is an unprecedented challenge and will require novel therapeutic strategies. Affected patients are likely to be at risk of arrhythmia due to underlying comorbidities, polypharmacy and the disease process. Importantly, a number of the medications likely to receive significant use can themselves, particularly in combination, be pro-arrhythmic. Read More

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http://dx.doi.org/10.3389/fcvm.2020.00085DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7214683PMC

Major Cardiac-Psychiatric Drug-Drug Interactions: a Systematic Review of the Consistency of Drug Databases.

Cardiovasc Drugs Ther 2020 May 19. Epub 2020 May 19.

Faculty of Medicine, University of Ottawa, Ottawa, Canada.

Purpose: Major depressive disorder (MDD) and anxiety disorders (AD) are both highly prevalent among individuals with arrhythmia, ischemic heart disease, heart failure, hypertension, and dyslipidemia. There should be increased support for MDD and AD diagnosis and treatment in individuals with cardiac diseases, because treatment rates have been low. However, cardiac-psychiatric drug interaction can make pharmacologic treatment challenging. Read More

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http://dx.doi.org/10.1007/s10557-020-06979-xDOI Listing

Complex and Novel Arrhythmias Precede Stillbirth in Fetuses With De Novo Long QT Syndrome.

Circ Arrhythm Electrophysiol 2020 May 18;13(5):e008082. Epub 2020 May 18.

Department of Medical Physics, University of Wisconsin-Madison (S.S. R.T.W.).

Background: Long QT syndrome (LQTS) is a leading cause of sudden cardiac death in early life and has been implicated in ≈10% of sudden infant deaths and unexplained stillbirths. The purpose of our study was to use fetal magnetocardiography to characterize the electrophysiology and rhythm phenotypes of fetuses with de novo and inherited LQTS variants and identify risk factors for sudden death before birth.

Methods: We reviewed the fetal magnetocardiography database from the University of Wisconsin Biomagnetism Laboratory for fetuses with confirmed LQTS. Read More

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http://dx.doi.org/10.1161/CIRCEP.119.008082DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7241276PMC

Cardiovascular safety of rapidly accelerated fibrosarcoma B-type and/or mitogen-activated extracellular signal-regulated kinase inhibitors: A mixed approach combining a meta-analysis and a pharmacovigilance disproportionality analysis.

Arch Cardiovasc Dis 2020 May 1. Epub 2020 May 1.

Department of Pharmacology, CHU de Caen, 14000 Caen, France; Department of Cardiology, CHU de Caen, 14000 Caen, France; Department of Dermatology, CHU de Caen, 14000 Caen, France.

Background: The risk of cardiovascular adverse events from rapidly accelerated fibrosarcoma B-type (BRAF) and mitogen-activated extracellular signal-regulated kinase (MEK) inhibitors is not fully characterized.

Aim: To evaluate the cardiovascular adverse events risks related to BRAF and/or MEK inhibitors in randomized placebo-controlled clinical trials and in the real-life setting.

Methods: We used two approaches. Read More

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http://dx.doi.org/10.1016/j.acvd.2020.03.014DOI Listing

Early experience with remdesivir in SARS-CoV-2 pneumonia.

Infection 2020 May 16. Epub 2020 May 16.

Division of Internal Medicine, University of Campania 'L. Vanvitelli', Monaldi Hospital, Piazzale Ettore Ruggieri, 80131, Naples, Italy.

At present, there is no definitive antiviral treatment for coronavirus disease 2019 (COVID-19). We describe our early experience with remdesivir in four critically ill COVID-19 patients. Patients received a 200 mg loading dose, followed by 100 mg daily intravenously for up to 10 days. Read More

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http://dx.doi.org/10.1007/s15010-020-01448-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229436PMC

Recommendations for the measurement of the QT interval during the use of drugs for COVID-19 infection treatment. Updatable in accordance with the availability of new evidence.

J Interv Card Electrophysiol 2020 May 16. Epub 2020 May 16.

International Center of Arrhythmias, Fundación CardioInfantilI-Instituto de Cardiología, Bogotá, Colombia.

COVID-19 infection has shown rapid growth worldwide, and different therapies have been proposed for treatment, in particular, the combination of immune response modulating drugs such as chloroquine and hydroxychloroquine (antimalarials) alone or in combination with azithromycin. Although the clinical evidence supporting their use is scarce, the off label use of these drugs has spread very quickly in face of the progression of the epidemic and the high mortality rate in susceptible populations. However, these medications can pathologically prolong the QT interval and lead to malignant ventricular arrhythmias such that organized guidance on QT evaluation and management strategies are important to reduce morbidity associated with the potential large-scale use. Read More

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http://dx.doi.org/10.1007/s10840-020-00765-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229438PMC

QT interval prolongation and torsade de pointes in patients with COVID-19 treated with hydroxychloroquine/azithromycin.

Heart Rhythm 2020 May 12. Epub 2020 May 12.

Leon H. Charney Division of Cardiology, Cardiac Electrophysiology, NYU Langone Health, New York University Grossman School of Medicine, New York, New York. Electronic address:

Background: There is no known effective therapy for patients with coronavirus disease 2019 (COVID-19). Initial reports suggesting the potential benefit of hydroxychloroquine/azithromycin (HY/AZ) have resulted in massive adoption of this combination worldwide. However, while the true efficacy of this regimen is unknown, initial reports have raised concerns about the potential risk of QT interval prolongation and induction of torsade de pointes (TdP). Read More

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http://dx.doi.org/10.1016/j.hrthm.2020.05.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7214283PMC

Torsade de pointes in initiating hemodialysis: a case report.

Ann Palliat Med 2020 May 6;9(3):1264-1268. Epub 2020 May 6.

Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.

Prolongation of the QT interval by antiarrhythmic drugs is the primary cause of torsade de pointes. Although there are previous reports of drug-induced torsade de pointes in patients undergoing hemodialysis, torsade de pointes caused by a sudden decrease of potassium levels in patients initiating hemodialysis has not been well described. A 70-year-old woman with recurrent bilateral gluteal abscesses visited the hospital for antibiotic treatment. Read More

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http://dx.doi.org/10.21037/apm.2020.04.29DOI Listing