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https://www.readbyqxmd.com/read/28728494/the-clinical-significance-of-qt-prolongation-associated-with-tamoxifen-a-review-of-the-literature
#1
Katherine Fung, Julia Imeson, Frances Cusano
Objective To review the literature discussing QT prolongation associated with the use of tamoxifen in order to evaluate the clinical significance. Data sources A search of PubMed (1946 to 2017), MEDLINE (1946 to 2017) and EMBASE (1947 to 2017) was performed using a combination of the following search terms: tamoxifen, estrogen antagonist, selective estrogen receptor modulator, QT prolongation, QT interval, long QT syndrome and torsades de pointes. All searches were limited to human subjects. Reference lists of the literature found were also reviewed but did not reveal any further articles...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28714380/loperamide-and-cardiac-events-is-high-dose-use-still-safe-for-chemotherapy-induced-diarrhea
#2
Mário L de Lemos, Jolene Guenter, Victoria Kletas
High-dose loperamide is often used for the acute management of chemotherapy-induced diarrhea, with a maximum daily dosing of up to 24 mg. Recently, the US Food and Drug Administration has issued a warning that loperamide can cause rare serious cardiac events, including QT prolongation, torsades de pointes, cardiac arrest and death. Most events were reported in patients taking very high doses for an extended period of time. Daily intake ranged from 64 mg to 1600 mg, often continuously for weeks or months...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28710299/takotsubo-cardiomyopathy-related-complete-heart-block-and-torsades-de-pointes
#3
Faisal Inayat, Hafeez Ul Hassan Virk, Waqas Ullah, Iqra Riaz
Takotsubo cardiomyopathy (TCM) is a relatively recently recognised clinical entity. It frequently mimics acute coronary syndrome and is accompanied by reversible left ventricular apical ballooning in the absence of angiographically significant coronary artery stenosis. TCM is a reversible condition, and the prognosis is usually well. However, in rare instances, it can be associated with life-threatening arrhythmic complications. Herein, we report the case of a patient with TCM who developed complete atrioventricular block followed by QT prolongation and torsades de pointes...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28692217/-magnesium-in-daily-practice
#4
Dany Minetto, Jacques Serratrice, Jérôme Stirnemann
The magnesium is the 4th cation in the human body behind sodium, potassium and calcium. It is often referred to as the forgotten cation of modern medicine because of a lack of knowledge about its physiology and its potential medical use. Recent medical literature has shown renewed interest for the magnesium with publications about its role in diversified fields from prevention of muscular cramps, cardiovascular risk factors prevention trough to neuroprotection in stroke. However, we cannot recommend the use of magnesium in adults in our clinical practice, beyond the simple correction of hypomagnesemia, pre-eclampsia and possibly the treatment of torsades de pointes...
October 19, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28674475/drug-induced-qt-prolongation-and-torsades-de-pointes
#5
Matthew Li, Liz G Ramos
Torsades de pointes (TdP)-an uncommon but life-threatening polymorphic ventricular tachycardia-is almost always drug induced. The authors describe the causes, risk factors, symptoms, diagnosis, and treatment of TdP.
July 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/28670758/congenital-long-qt-syndrome-and-torsade-de-pointes
#6
REVIEW
Nabil El-Sherif, Gioia Turitto, Mohamed Boutjdir
Since its initial description by Jervell and Lange-Nielsen in 1957, the congenital long QT syndrome (LQTS) has been the most investigated cardiac ion channelopathy. A prolonged QT interval in the surface electrocardiogram is the sine qua non of the LQTS and is a surrogate measure of the ventricular action potential duration (APD). Congenital as well as acquired alterations in certain cardiac ion channels can affect their currents in such a way as to increase the APD and hence the QT interval. The inhomogeneous lengthening of the APD across the ventricular wall results in dispersion of APD...
July 2, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28663351/dofetilide-induced-torsade-de-pointes-in-high-grade-atrioventricular-node-dysfunction
#7
Ali A Alsaad, Scott M Silvers, Fred Kusumoto, Joseph L Blackshear
No abstract text is available yet for this article.
June 29, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28659221/qtc-interval-in-patients-with-schizophrenia-receiving-antipsychotic-treatment-as-monotherapy-or-polypharmacy
#8
Anja Elliott, Thibault Johan Mørk, Mikkel Højlund, Thomas Christensen, Rasmus Jeppesen, Nikolaj Madsen, Anne Grethe Viuff, Peter Hjorth, Jens Cosedis Nielsen, Povl Munk-Jørgensen
OBJECTIVE: Antipsychotics are associated with a polymorphic ventricular tachycardia, torsades de pointes, which, in the worst case, can lead to sudden cardiac death. The QT interval corrected for heart rate (QTc) is used as a clinical proxy for torsades de pointes. The QTc interval can be prolonged by antipsychotic monotherapy, but it is unknown if the QTc interval is prolonged further with antipsychotic polypharmaceutical treatment. Therefore, this study investigated the associations between QTc interval and antipsychotic monotherapy and antipsychotic polypharmaceutical treatment in schizophrenia, and measured the frequency of QTc prolongation among patients...
June 29, 2017: CNS Spectrums
https://www.readbyqxmd.com/read/28653942/torsade-de-pointes-in-a-patient-with-severe-hypercalcaemia-and-multiple-myeloma
#9
D Fuchs, D Voskova, K J Krenosz, T Lambert, M A Fridrik
We report a case of a 48-year-old female patient with newly diagnosed multiple myeloma. She developed recurrent torsade de pointes and required cardiopulmonary resuscitation and defibrillation. Atrial arrhythmias in patients with multiple myeloma and hypercalcaemia have been described, but, to the best of our knowledge, this is the first report of torsade de pointes in this setting.
June 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28652909/a-case-of-hypoglycemiainduced-qt-prolongation-leading-to-torsade-de-pointes-and-a-review-of-pathophysiological-mechanisms
#10
Faris Hannoodi, Hashim Alwash, Kushal Shah, Israa Ali, Sarwan Kumar, Khalid Zakaria
Torsades de pointes is a life-threatening cardiac arrhythmia. Occurrence of this arrhythmia as a result of hypoglycemia has not been reported in the literature. We describe an interesting case of an insulin-dependent diabetic patient presenting with torsades de pointes resulting from hypoglycemia. A 62-year-old male was admitted to the hospital following an episode of severe insulin-induced hypoglycemia and a cardiac arrest. He was found to unresponsive at home after taking insulin. His serum glucose was found to be 18...
June 7, 2017: Clinics and Practice
https://www.readbyqxmd.com/read/28652681/recurrent-takotsubo-syndrome-with-long-qtc-and-torsade-de-pointes-can-cellular-phone-based-acquisition-transmission-of-electrocardiogram-be-of-value
#11
John E Madias
No abstract text is available yet for this article.
July 2017: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/28645448/takotsubo-syndrome-presenting-as-syncope-in-a-patient-with-permanent-pacemaker
#12
Bharatraj Banavalikar, Sivasankaran Sivasubramonian, Narayanan Namboodiri, Krishna Kumar Mohanan Nair, Dibya Ranjan Behera, Ajitkumar Valaparambil
Takotsubo syndrome is an acute reversible heart failure syndrome triggered by physical or emotional stress, especially in postmenopausal women. Herein, we describe a case of a 31-year-old pacemaker dependent lady who presented with syncope after she was bereaved of her father. Electrocardiogram at admission revealed ventricular paced rhythm at 60/min, prolonged QT interval and frequent runs of torsades de pointes. Transthoracic echocardiogram and left ventriculogram revealed findings typical of Takotsubo syndrome...
May 18, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28638664/torsade-de-pointes-induced-by-hypokalemia-from-imipenem-and-piperacillin
#13
Varun Kumar, Sandeep Khosla, Monica Stancu
Imipenem-cilastatin and piperacillin-tazobactam are two antibiotics with broad antimicrobial coverage. Besides the many well established adverse effects of these drugs, there have been few case reports of hypokalemia. Here we present an interesting case of resistant hypokalemia caused by these drugs leading to Torsades de Pointes which has never been reported in the past. Hypokalemia resolved with discontinuation of piperacillin.
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28624975/deleterious-acute-and-chronic-effects-of-bradycardic-right-ventricular-apex-pacing-consequences-for-arrhythmic-outcome
#14
T R G Stams, A Dunnink, W M van Everdingen, H D M Beekman, R van der Nagel, B Kok, M F A Bierhuizen, M J Cramer, M Meine, M A Vos
In the chronic complete atrioventricular (AV) block dog (CAVB) model, both bradycardia and altered ventricular activation due to the uncontrolled idioventricular rhythm contribute to ventricular remodeling and the enhanced susceptibility to Torsade de Pointes (TdP) arrhythmias. We investigated the effect of permanent bradycardic right ventricular apex (RVA) pacing on mechanical and electrical remodeling and TdP. In 23 anesthetized dogs, serial experiments were performed at sinus rhythm (SR), acutely after AV block (AAVB) and 3 weeks of remodeling CAVB at a fixed pacing rate of 60/min...
July 2017: Basic Research in Cardiology
https://www.readbyqxmd.com/read/28617967/holter-monitored-sudden-cardiac-arrest-after-atrioventricular-junction-ablation
#15
Victor Waldmann, Eloi Marijon, Nicolas Combes
We present a case of sudden cardiac arrest seven hours after radiofrequency ablation of the atrioventricular junction for symptomatic permanent atrial fibrillation unresponsive to medical therapy. The Holter monitoring revealed a progressive increasing of QT interval after the procedure, highlighting the repolarization instability after acute changes in heart rates associated with modification of ventricular activation, leading to occurrence of short coupling interval ventricular extra beats and finally to a "Torsade de Pointes"...
June 15, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28612303/additive-proarrhythmic-effect-of-combined-treatment-with-qt-prolonging-agents
#16
Gerrit Frommeyer, Christina Fischer, Christian Ellermann, Dirk G Dechering, Simon Kochhäuser, Philipp S Lange, Kristina Wasmer, Michael Fehr, Lars Eckardt
Drug combinations may elevate the risk of proarrhythmia. The aim of the present study was to investigate whether combinations of non-cardiovascular agents induce an additive increase in the proarrhythmic risk. In 12 female rabbit hearts, a drug combination of cotrimoxazole (300 µM), ondansetron (5 µM) and domperidone (1 µM) was infused after obtaining baseline data. In another 13 hearts, a combination of cotrimoxazole (300 µM), ondansetron (5 µM) and erythromycin (300 µM) was infused. Monophasic action potentials and ECG displayed a significant QT prolongation in all groups...
June 13, 2017: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/28607621/epicardially-placed-implantable-cardioverter-defibrillator-for-a-child-with-congenital-long-qt-syndrome
#17
Hirotaro Sugiyama, Motomi Tachibana, Hiroshi Morita, Nobuhiro Nishii, Akihito Miyoshi, Hiroyasu Sugiyama, Koji Nakagawa, Atsuyuki Watanabe, Kazufumi Nakamura, Hiroshi Ito
A 7-year-old boy presented at our hospital with syncope. At birth, electrocardiography had shown a long QT interval with torsade de pointes (TdP). Congenital long QT syndrome (LQTS) had been diagnosed by genetic testing, and was successfully controlled with oral propranolol. At age 7, TdP had recurred with syncope. Electrocardiography revealed a prominent long QT interval with T-wave alternans. The propranolol dose was increased, but TdP remained uncontrolled. A cardioverter-defibrillator (ICD) was implanted epicardially, and TdP completely resolved with atrial pacing...
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28606196/prescribing-an-automated-external-defibrillator-for-children-at-increased-risk-of-sudden-arrhythmic-death
#18
Karen A McLeod, Eileen Fern, Fiona Clements, Ruth McGowan
BACKGROUND: Automated external defibrillators can be life-saving in out-of-hospital cardiac arrest. OBJECTIVE: Our aim was to review our experience of prescribing automated external defibrillators for children at increased risk of sudden arrhythmic death. METHODS: We reviewed all automated external defibrillators issued by the Scottish Paediatric Cardiac Electrophysiology Service from 2005 to 2015. All parents were given resuscitation training according to the Paediatric Resuscitation Guidelines, including the use of the automated external defibrillator...
June 13, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28590366/effect-of-gwas-identified-genetic-variants-on-maximum-qt-interval-in-patients-with-schizophrenia-receiving-antipsychotic-agents-a-24-hour-holter-ecg-study
#19
Junzo Watanabe, Naoki Fukui, Yutaro Suzuki, Takuro Sugai, Shin Ono, Nobuto Tsuneyama, Mami Saito, Misuzu Tajiri, Toshiyuki Someya
BACKGROUND: Users of antipsychotics (APs) have a risk of sudden cardiac death (SCD). Sudden cardiac death in such patients is thought to be largely due to drug-induced QT prolongation. It has been reported that many subjects with drug-induced torsades de pointes (TdP) have risk alleles associated with subclinical congenital long QT syndrome. METHODS: We investigated the effects of the risk alleles associated with long QT on the QT interval in patients receiving APs using 24-hour Holter electrocardiograms to take into account the circadian fluctuation of QT intervals...
August 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28583014/evaluation-of-the-effects-of-quetiapine-on-qtc-prolongation-in-critically-ill-patients
#20
Kevin M Dube, Jeremy DeGrado, Benjamin Hohlfelder, Paul M Szumita
Quetiapine, an atypical antipsychotic used in the intensive care unit (ICU) to manage delirium, has a possible adverse effect of corrected QT (QTc) interval prolongation. The objective of this analysis was to describe the impact of quetiapine on QTc interval prolongation in critically ill patients. This was a single-center, prospective cohort analysis of ICU patients who received quetiapine between October 2015 and February 2016. The major end point was the incidence of QTc prolongation greater than 60 milliseconds above baseline during therapy...
January 1, 2017: Journal of Pharmacy Practice
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