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Torsades de Pointes

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https://www.readbyqxmd.com/read/29923812/the-identification-of-torsades-de-pointes-via-ceeg-a-case-report-on-a-patient-with-physiologically-provoked-nonepileptic-events
#1
Andrew Todd Ham, Jill Mackey, Gary Semb
Continuous electroencephalography (CEEG) is chiefly performed at The Medical University of South Carolina (MUSC) for identifying seizures, including its refined use within the epilepsy monitoring unit (EMU) as a differentiator between epileptic and psychogenic etiologies. CEEG also provides critical data that carry implications outside the bounds of both epilepsy and psychogenic events, such as the characterization of unorthodox clinical phenomena that are of physiological (though nonepileptic) origins. Although nonepileptic events (NEEs) are primarily linked with psychogenic phenomena (conversion disorder, malingering) that can mimic epileptic activity, they, like seizures, have diverse semiologies and etiologies...
2018: Neurodiagnostic Journal
https://www.readbyqxmd.com/read/29920724/afterdepolarizations-and-triggered-activity-as-a-mechanism-for-clinical-arrhythmias
#2
REVIEW
Andrew L Wit
Afterdepolarizations cause triggered arrhythmias. One kind occurs after repolarization is complete, delayed afterdepolarizations (DADs). Another occurs as an interruption in repolarization, early afterdepolarizations (EADs). Afterdepolarizations initiate arrhythmias when they depolarize membrane potential to threshold potential for triggering action potentials. DADs usually occur mostly when Ca2+ in the sarcoplasmic reticulum (SR) is elevated. The SR leaks some of the Ca2+ into the myoplasm through Ca2+ release channels controlled by ryanodine receptors (RyR2) during diastole...
June 19, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29916560/sex-drugs-and-heart-failure-a-sex-sensitive-review-of-the-evidence-base-behind-current-heart-failure-clinical-guidelines
#3
REVIEW
Anna Levinsson, Marie-Pierre Dubé, Jean-Claude Tardif, Simon de Denus
Heart failure (HF) is a complex disease, almost as common in women as in men. Nonetheless, HF clinical presentation, prognosis, and aetiology vary by sex. This review summarizes the current state of sex-sensitive issues related to HF drugs included in treatment guidelines and suggests future directions for improved care. Heart failure presentation differs between female and male patients: females more often show with hypertensive aetiology and the preserved ejection fraction phenotype, while men more often show ischaemic aetiology and the reduced ejection fraction phenotype...
June 19, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29904445/malignant-ventricular-arrhythmias-resulting-from-drug-induced-qtc-prolongation-a-retrospective-study
#4
Renato De Vecchis, Carmelina Ariano, Giuseppina Di Biase, Michel Noutsias
Background: Several drug classes (antiarrhythmics, antimicrobials, antidepressants, phenothiazines, opiates, prokinetics of digestive tract, etc.) have been related to ventricular hyperkinetic arrhythmias such as torsade de pointes (TdP). TdPs are usually heralded by an abnormal prolongation of heart rate-corrected QT interval on the electrocardiogram, so-called drug-induced long heart rate-corrected QT (diLQTc). We don't know to what extent the drug-induced QTc prolongation is able to predict malignant arrhythmias...
July 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29894447/corrected-qt-interval-prolongation-in-hospitalized-pediatric-patients-receiving-methadone
#5
Amy J Schwinghammer, Machelle D Wilson, Brent A Hall
OBJECTIVES: Methadone is often used in pediatric patients to prevent or treat opioid withdrawal after prolonged sedation. Prolonged corrected QT interval is an important adverse effect of methadone because it can progress to torsades de pointes, a potentially fatal dysrhythmia. The prevalence of corrected QT interval prolongation and contributing risk factors are not well defined in hospitalized pediatric patients receiving methadone. The study purpose was to identify the frequency and risk factors of corrected QT interval prolongation in hospitalized pediatric patients receiving methadone...
June 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29887431/the-power-of-the-patch-a-smart-way-to-track-risk-for-torsades-de-pointes-in-congenital-and-drug-induced-long-qt-syndromes
#6
EDITORIAL
Richard L Verrier
No abstract text is available yet for this article.
September 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29882591/predictive-analytics-for-identification-of-patients-at-risk-for-qt-interval-prolongation-a-systematic-review
#7
Elena Tomaselli Muensterman, James E Tisdale
Prolongation of the heart rate-corrected QT (QTc) interval increases the risk for torsades de pointes (TdP), a potentially fatal arrhythmia. The likelihood of TdP is higher in patients with risk factors, which include female sex, older age, heart failure with reduced ejection fraction, hypokalemia, hypomagnesemia, concomitant administration of ≥ 2 QTc interval-prolonging medications, among others. Assessment and quantification of risk factors may facilitate prediction of patients at highest risk for developing QTc interval prolongation and TdP...
June 8, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29876021/anticancer-drugs-related-qtc-prolongation-torsade-de-pointes-and-sudden-death-current-evidence-and-future-research-perspectives
#8
REVIEW
Jialin Duan, Jingwen Tao, Maocai Zhai, Chengpeng Li, Ning Zhou, Jiagao Lv, Lin Wang, Li Lin, Rong Bai
Anticancer drugs may have proarrhythmic effects including drug-induced QT interval prolongation, which is of particular importance because it can lead to a fatal polymorphic ventricular tachycardia termed torsade de pointes (TdP). QT interval prolongation and TdP are rare life-threatening untoward effects of anticancer therapy, particularly with arsenic trioxides and anthracyclines, and even some novel molecular targeted drugs touted as 'tumor specific'. Several factors that affect myocardial repolarization can further increase the risk of TdP...
May 22, 2018: Oncotarget
https://www.readbyqxmd.com/read/29874922/cardiovascular-safety-of-psychiatric-agents-a-cautionary-tale
#9
Theodora A Manolis, Antonis A Manolis, Antonis S Manolis
Psychiatric agents are among the most commonly prescribed medications. Despite the advent of newer generation agents, patients receiving them still experience cardiovascular (CV) side effects. However, these agents may have heterogeneous properties, calling for an individualized approach based on efficacy and also on the particular side effect profile of each specific agent. Proarrhythmic effects arising from drug-induced long-QT syndrome and consequent potentially life-threatening polymorphic ventricular arrhythmias in the form of torsade de pointes, the metabolic syndrome contributing to atherosclerosis and acute coronary syndromes, and drug-induced orthostatic hypotension raise major concerns...
January 1, 2018: Angiology
https://www.readbyqxmd.com/read/29862236/effects-of-atypical-antipsychotic-drugs-on-qt-interval-in-patients-with-mental-disorders
#10
Wilbert S Aronow, Tatyana A Shamliyan
Background: Drug-induced QT prolongation is associated with higher risk of cardiac arrhythmias and cardiovascular mortality. We investigated the effects of atypical antipsychotic drugs on QT interval in children and adults with mental disorders. Methods: We conducted random-effects direct frequentist meta-analyses of aggregate data from randomized controlled trials (RCT) and appraised the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology...
April 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29859851/quizartinib-an-flt3-inhibitor-as-monotherapy-in-patients-with-relapsed-or-refractory-acute-myeloid-leukaemia-an-open-label-multicentre-single-arm-phase-2-trial
#11
Jorge Cortes, Alexander E Perl, Hartmut Döhner, Hagop Kantarjian, Giovanni Martinelli, Tibor Kovacsovics, Philippe Rousselot, Björn Steffen, Hervé Dombret, Elihu Estey, Stephen Strickland, Jessica K Altman, Claudia D Baldus, Alan Burnett, Alwin Krämer, Nigel Russell, Neil P Shah, Catherine C Smith, Eunice S Wang, Norbert Ifrah, Guy Gammon, Denise Trone, Deborah Lazzaretto, Mark Levis
BACKGROUND: Old age and FMS-like tyrosine kinase 3 internal tandem duplication (FLT3-ITD) mutations in patients with acute myeloid leukaemia are associated with early relapse and poor survival. Quizartinib is an oral, highly potent, and selective next-generation FLT3 inhibitor with clinical antileukaemic activity in relapsed or refractory acute myeloid leukaemia. We aimed to assess the efficacy and safety of single-agent quizartinib in patients with relapsed or refractory acute myeloid leukaemia...
May 30, 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29850230/electrocardiogram-changes-of-donepezil-administration-in-elderly-patients-with-ischemic-heart-disease
#12
Deguo Wang, Yong Wu, Ancai Wang, Yueyun Chen, Ting Zhang, Nengwei Hu
Objective: Donepezil, a widely used cholinesterase inhibitor for treating Alzheimer's disease, has been reported to induce bradyarrhythmias and torsade de pointes. In this study, we aimed at determining electrocardiogram changes of donepezil administration in elderly patients with ischemic heart disease, who tend to suffer from cognitive disorders. Methods: Sixty patients with ischemic heart disease and mild cognitive impairment were treated with donepezil (5 mg/day) and followed up for at least four weeks...
2018: Cardiology Research and Practice
https://www.readbyqxmd.com/read/29806042/performance-of-machine-learning-algorithms-for-qualitative-and-quantitative-prediction-drug-blockade-of-herg1-channel
#13
Soren Wacker, Sergei Yu Noskov
Drug-induced abnormal heart rhythm known as Torsades de Pointes (TdP) is a potential lethal ventricular tachycardia found in many patients. Even newly released anti-arrhythmic drugs, like ivabradine with HCN channel as a primary target, block the hERG potassium current in overlapping concentration interval. Promiscuous drug block to hERG channel may potentially lead to perturbation of the action potential duration (APD) and TdP, especially when with combined with polypharmacy and/or electrolyte disturbances...
May 2018: Computational Toxicology
https://www.readbyqxmd.com/read/29793933/tetrodotoxin-sensitive-na-v-s-contribute-to-early-and-delayed-afterdepolarizations-in-long-qt-arrhythmia-models
#14
Megan Koleske, Ingrid Bonilla, Justin Thomas, Naveed Zaman, Stephen Baine, Bjorn C Knollmann, Rengasayee Veeraraghavan, Sándor Györke, Przemysław B Radwański
Recent evidence suggests that neuronal Na+ channels (nNav s) contribute to catecholamine-promoted delayed afterdepolarizations (DADs) and catecholaminergic polymorphic ventricular tachycardia (CPVT). The newly identified overlap between CPVT and long QT (LQT) phenotypes has stoked interest in the cross-talk between aberrant Na+ and Ca2+ handling and its contribution to early afterdepolarizations (EADs) and DADs. Here, we used Ca2+ imaging and electrophysiology to investigate the role of Na+ and Ca2+ handling in DADs and EADs in wild-type and cardiac calsequestrin (CASQ2)-null mice...
May 23, 2018: Journal of General Physiology
https://www.readbyqxmd.com/read/29784533/long-qt-syndrome-a-comprehensive-review-of-the-literature-and-current-evidence
#15
REVIEW
Syed Raza Shah, Ki Park
Long QT syndrome (LQT) represents a heterogeneous family of cardiac electrophysiologic disorders characterized by QT prolongation and T-wave abnormalities on the electrocardiogram. It is commonly associated with syncope, however, sudden cardiac death can occur due to torsades de pointes. LQT is a clinical diagnosis and should be suspected in individuals on the basis of clinical presentation, family history and electrocardiogram characteristics. Management is focused on the prevention of syncope and ultimately sudden death...
May 10, 2018: Current Problems in Cardiology
https://www.readbyqxmd.com/read/29759840/twisting-and-turning-to-find-an-explanation-for-torsades-de-pointes
#16
EDITORIAL
Sachin Nayyar, Andreu Porta-Sánchez, Kumaraswamy Nanthakumar
No abstract text is available yet for this article.
December 26, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759839/short-lasting-episodes-of-torsade-de-pointes-in-the-chronic-atrioventricular-block-dog-model-have-a-focal-mechanism-while-longer-lasting-episodes-are-maintained-by-re-entry
#17
Nele Vandersickel, Alexandre Bossu, Jan De Neve, Albert Dunnink, Veronique M F Meijborg, Marcel A G van der Heyden, Jet D M Beekman, Jacques M T De Bakker, Marc A Vos, Alexander V Panfilov
OBJECTIVES: This study investigated the arrhythmogenic mechanisms responsible for torsade de pointes (TdP) in the chronic atrioventricular block dog model, known for its high susceptibility for TdP. BACKGROUND: The mechanism of TdP arrhythmias has been under debate for many years. Focal activity as well as re-entry have both been mentioned in the initiation and the perpetuation of TdP. METHODS: In 5 TdP-sensitive chronic atrioventricular block dogs, 56 needle electrodes were evenly distributed transmurally to record 240 unipolar local electrograms simultaneously...
December 26, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29754959/human-induced-pluripotent-stem-cell-derived-cardiac-cell-sheets-expressing-genetically-encoded-voltage-indicator-for-pharmacological-and-arrhythmia-studies
#18
Naim Shaheen, Assad Shiti, Irit Huber, Rami Shinnawi, Gil Arbel, Amira Gepstein, Noga Setter, Idit Goldfracht, Amit Gruber, Snizhanna V Chorna, Lior Gepstein
Fulfilling the potential of human induced pluripotent stem cell (hiPSC)-derived cardiomyocytes for studying conduction and arrhythmogenesis requires development of multicellular models and methods for long-term repeated tissue phenotyping. We generated confluent hiPSC-derived cardiac cell sheets (hiPSC-CCSs), expressing the genetically encoded voltage indicator ArcLight. ArcLight-based optical mapping allowed generation of activation and action-potential duration (APD) maps, which were validated by mapping the same hiPSC-CCSs with the voltage-sensitive dye, Di-4-ANBDQBS...
May 7, 2018: Stem Cell Reports
https://www.readbyqxmd.com/read/29753687/istaroxime-a-positive-inotropic-agent-devoid-of-proarrhythmic-properties-in-sensitive-chronic-atrioventricular-block-dogs
#19
Alexandre Bossu, Amée Kostense, Henriette D M Beekman, Marien J C Houtman, Marcel A G van der Heyden, Marc A Vos
Current inotropic agents in heart failure therapy associate with low benefit and significant adverse effects, including ventricular arrhythmias. Istaroxime, a novel Na+ /K+ -transporting ATPase inhibitor, also stimulates SERCA2a activity, which would confer improved inotropic and lusitropic properties with less proarrhythmic effects. We investigated hemodynamic, electrophysiological and potential proarrhythmic and antiarrhythmic effects of istaroxime in control and chronic atrioventricular block (CAVB) dogs sensitive to drug-induced Torsades de Pointes arrhythmias (TdP)...
May 10, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29738372/paradoxical-effects-of-sodium-calcium-exchanger-inhibition-on-torsade-de-pointes-and-early-afterdepolarization-in-a-heart-failure-rabbit-model
#20
Po-Cheng Chang, Yu-Ying Lu, Hui-Ling Lee, Shien-Fong Lin, Yen Chu, Ming-Shien Wen, Chung-Chuan Chou
Calcium homeostasis plays an important role in development of early afterdepolarizations (EADs) and torsade de pointes (TdP). The role of sodium-calcium exchanger (NCX) inhibition in genesis secondary Ca rise and EADs-TdP is still debated. Dual voltage and intracellular Ca optical mapping were conducted in 6 control and 9 failing rabbit hearts. After baseline electrophysiological and optical mapping studies, E4031 was given to simulate long QT syndrome. ORM-10103 was then administrated to examine the electrophysiological effects on EAD-TdP development...
May 3, 2018: Journal of Cardiovascular Pharmacology
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