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torsade de pointes

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https://www.readbyqxmd.com/read/29162767/an-increasing-electromechanical-window-is-a-predictive-marker-of-ventricular-fibrillation-in-anesthetized-rabbit-with-ischemic-heart
#1
Vudhiporn Limprasutr, Prapawadee Pirintr, Anusak Kijtawornrat, Robert L Hamlin
The QTc interval is widely used in Safety Pharmacological studies to predict arrhythmia risk, and the electromechanical window (EMW) and short-term variability of QT intervals (STVQT) have been studied as new biomarkers for drug-induced Torsades de Pointes (TdP). However, the use of EMW and STVQT to predict ventricular fibrillation (VF) has not been elucidated. This study aimed to evaluate EMW and STVQT to predict VF in anesthetized rabbit model of VF. VF was induced by ligation of the left anterior descending and a descending branch of the left circumflex coronary arteries in a sample population of rabbits (n=18)...
November 21, 2017: Experimental Animals
https://www.readbyqxmd.com/read/29157021/gastroparesis-pharmacotherapy-and-cardiac-risk
#2
Per M Hellström, Ahmad Al-Saffar
BACKGROUND: Gastroparesis is characterized by abnormal gastric motility and delayed emptying with symptoms of early satiety, postprandial fullness, bloating, nausea, vomiting and abdominal pain. Pharmacological discovery has been lagging because potential drugs often are associated with abnormalities of electrical conduction of the myocardium due to interaction with cardiac ion channels leading to limited pharmaceutical options for development of new drugs. OBJECTIVE: Addresses the safety of drugs for gastroparesis in terms of cardiotoxicity related to the clinical use of prokinetics and antiemetics...
November 20, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29151524/atrioventricular-block-induced-torsades-de-pointes-associated-with-kcnq1-g269s
#3
Tadashi Nakajima, Takashi Sugawara, Yoshiaki Kaneko, Masahiko Kurabayashi
No abstract text is available yet for this article.
November 20, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29147476/sudden-cardiac-arrest-as-a-rare-presentation-of-myxedema-coma-case-report
#4
Divya Salhan, Deepak Sapkota, Prakash Verma, Saroj Kandel, Omar Abdulfattah, Antony Lixon, Deribe Zwenge, Frances Schmidt
Myxedema coma is a decompensated hypothyroidism which occurs due to long-standing, undiagnosed, or untreated hypothyroidism. Untreated hypothyroidism is known to affect almost all organs including the heart. It is associated with a decrease in cardiac output, stroke volume due to decreased myocardial contractility, and an increase in systemic vascular resistance. It can cause cardiac arrhythmias and the most commonly seen conduction abnormalities are sinus bradycardia, heart block, ventricular tachycardia, and torsade de pointes...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29146275/beat-to-beat-variations-in-activation-recovery-interval-derived-from-the-right-ventricular-electrogram-can-monitor-arrhythmic-risk-under-anesthetic-and-awake-conditions-in-the-canine-chronic-atrioventricular-block-model
#5
Sofieke C Wijers, David J Sprenkeler, Alexandre Bossu, Albert Dunnink, Jet D M Beekman, Rosanne Varkevisser, Alfonso Aranda Hernández, Mathias Meine, Marc A Vos
BACKGROUND: In the chronic atrioventricular block (CAVB) dog model, beat-to-beat variation of repolarization in the left ventricle (LV) quantified as short-term variability of the left monophasic action potential duration (STVLVMAPD) increases abruptly upon challenge with a pro arrhythmic drug. This increase occurs before the first ectopic beat (EB), specifically in subjects that demonstrate subsequent repetitive Torsade de Pointes arrhythmias (TdP). OBJECTIVE: Demonstrate that STV is feasible to monitor arrhythmic risk through the use of the intracardiac electrogram (EGM) derived from the right ventricle (RV) lead from pacemakers or implantable cardioverter defibrillators (ICD)...
November 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29145929/ciprofloxacin-does-not-prolong-the-qtc-interval-a-clinical-study-in-icu-patients-and-review-of-the-literature
#6
Charlotte Heemskerk, Evelien Woldman, Marieke Pereboom, Ruud Van der Hoeven, Aukje Mantel-Teeuwisse, Claudia Van Gemeren, Matthijs Lambertus Becker
PURPOSE: Ciprofloxacin may prolong the QT interval and increase the risk of Torsade de Pointes (TdP). Intravenous administration of ciprofloxacin in patients with additional risks may elevate the risk of QTc interval prolongation. We prospectively assessed whether intravenous ciprofloxacin prolongs the QT interval in patients with additional co-morbidities and risk factors. We also reviewed the literature on the QT prolonging effect or TdP inducing effect of ciprofloxacin. METHODS: ICU Patients who were treated with intravenous ciprofloxacin as part of their therapy were recruited...
2017: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29139031/in-vivo-analysis-of-the-anti-atrial-fibrillatory-proarrhythmic-and-cardiodepressive-profiles-of-dronedarone-as-a-guide-for-safety-pharmacological-evaluation-of-antiarrhythmic-drugs
#7
Yoshiyuki Motokawa, Yuji Nakamura, Mihoko Hagiwara-Nagasawa, Ai Goto, Koki Chiba, Nur Jaharat Lubna, Hiroko Izumi-Nakaseko, Kentaro Ando, Atsuhiko T Naito, Hiroshi Yamazaki, Atsushi Sugiyama
Anti-atrial fibrillatory, proarrhythmic and cardiodepressive profiles of dronedarone were analyzed using the halothane-anesthetized beagle dogs (n = 4) to create a standard protocol for clarifying both efficacy and adverse effects of anti-atrial fibrillatory drugs. Intravenous administration of dronedarone hydrochloride in doses of 0.3 and 3 mg/kg over 30 s attained the peak plasma concentrations of 61 and 1248 ng/mL, respectively, reflecting sub- to supra-therapeutic ones. The low dose decreased the left ventricular contraction and mean blood pressure, which were enhanced at the high dose...
November 14, 2017: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/29126547/microvolt-t-wave-alternans-monitoring-in-a-patient-with-levofloxacin-induced-torsade-de-pointes
#8
Yuki Sahashi, Nobuhiro Takasugi, Genki Naruse, Tomoki Kubota, Kazuhiko Nishigaki, Shinya Minatoguchi
We present the case of a 62-year-old woman with levofloxacin-induced Torsade de Pointes, in whom microvolt T-wave alternans was measured during acute hospitalization and when QT interval was dynamically changing, illustrating a means for monitoring proarrhythmia.
September 27, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29114797/thyroid-dysfunction-in-torsades-de-pointes-reply
#9
Saman Rezazadeh, Robert J H Miller, Derek S Chew
No abstract text is available yet for this article.
November 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29114788/thyroid-dysfunction-in-torsades-de-pointes
#10
Ali A Rizvi
No abstract text is available yet for this article.
November 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29057872/modelling-torsade-de-pointes-arrhythmias-in-vitro-in-3d-human-ips-cell-engineered-heart-tissue
#11
Masahide Kawatou, Hidetoshi Masumoto, Hiroyuki Fukushima, Gaku Morinaga, Ryuzo Sakata, Takashi Ashihara, Jun K Yamashita
Torsade de Pointes (TdP) is a lethal arrhythmia that is often drug-induced, thus there is an urgent need for development of models to test or predict the drug sensitivity of human cardiac tissue. Here, we present an in vitro TdP model using 3D cardiac tissue sheets (CTSs) that contain a mixture of human induced pluripotent stem cell (hiPSC)-derived cardiomyocytes and non-myocytes. We simultaneously monitor the extracellular field potential (EFP) and the contractile movement of the CTSs. Upon treatment with IKr channel blockers, CTSs exhibit tachyarrhythmias with characteristics of TdP, including both a typical polymorphic EFP and meandering spiral wave re-entry...
October 20, 2017: Nature Communications
https://www.readbyqxmd.com/read/29057492/qtc-prolongation-during-ciprofloxacin-and-fluconazole-combination-therapy-prevalence-and-associated-risk-factors
#12
Florine A Berger, Nico Monadian, Natasja M S de Groot, Bart Santbergen, Heleen van der Sijs, Matthijs L Becker, Annoek E C Broers, Teun van Gelder, Patricia M L A van den Bemt
AIM (S): Ciprofloxacin and fluconazole combination therapy is frequently used as prophylaxis for and treatment of infections in patients with haematological malignancies. However, both drugs are known to prolong the QTc-interval, which is a serious risk factor for Torsade de Pointes (TdP). Therefore, the aim of this study was to assess the prevalence of QTc-prolongation during ciprofloxacin and fluconazole use. The secondary objective was to determine associated risk factors of QTc-prolongation in these patients...
October 22, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29057193/long-qt-syndrome-unveiled-by-a-fatal-combination-of-medications-and-electrolyte-abnormalities
#13
Pooja Sethi, Jennifer Treece, Vandana Pai, Chidinma Onweni
Long QT syndrome (LQTS) can present with syncope and seizure-like activity in the setting of torsades de pointes (TdP) with hemodynamic instability. Electrolyte abnormalities and medications can predispose to TdP in the setting of latent LQTS. An implantable cardioverter defibrillator (ICD) is needed if patients with TdP continue to be symptomatic despite medical treatment. We report a case of a patient who presented with seizures and was found to have prolonged corrected QT interval (QTc). During her admission, she was treated with ondansetron...
August 18, 2017: Curēus
https://www.readbyqxmd.com/read/29038104/safety-of-oral-dofetilide-reloading-for-treatment-of-atrial-arrhythmias
#14
Jae Hyung Cho, So Jin Youn, JoEllyn C Moore, Roxanne Kyriakakis, Carolyn Vekstein, Michael Militello, Stacy M Poe, Kathy Wolski, Patrick J Tchou, Niraj Varma, Mark J Niebauer, Mandeep Bhargava, Walid I Saliba, Oussama M Wazni, Bruce D Lindsay, Bruce L Wilkoff, Mina K Chung
BACKGROUND: Although dofetilide labeling states that the drug must be initiated or reinitiated with continuous electrocardiographic monitoring and in the presence of trained personnel, the risks of dofetilide reloading justifying repeat hospitalization have not been investigated. METHODS AND RESULTS: Patients admitted for dofetilide reloading for atrial arrhythmias were retrospectively reviewed. The need for dose adjustment and the incidence of torsades de pointes (TdP) were identified...
October 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29037423/unique-ecg-presentations-and-clinical-management-of-a-symptomatic-lqt2-female-carrying-a-novel-de-novo-kcnh2-mutation
#15
Chunlin Yin, Ping Zhang, Jing Yang, Li Zhang
A 26-year-old woman, 12 days in postpartum, developed recurrent syncope and cardiac arrest. Her ECG revealed QT-prolongation associated with LQT2-specific T-U wave patterns, T wave alternans, long QT-dependent torsade de pointes (TdP) and ventricular fibrillation (VF). She also had intermittent LBBB (80bpm) on alternate beats and RBBB at sinus tachycardia (113bpm). Family genotyping revealed a novel de novo missense mutation G604C of KCNH2. Propranolol slowed heart rate and further prolonged QT interval (610ms) that caused TdP recurrence...
August 17, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29021858/landiolol-suppression-of-electrical-storm-of-torsades-de-pointes-in-patients-with-congenital-long-qt-syndrome-type-2-and-myocardial-ischemia
#16
Ryota Kitajima, Takeshi Aiba, Tsukasa Kamakura, Kohei Ishibashi, Mitsuru Wada, Yuko Inoue, Koji Miyamoto, Hideo Okamura, Takashi Noda, Satoshi Nagase, Yu Kataoka, Yasuhide Asaumi, Teruo Noguchi, Satoshi Yasuda, Kengo Kusano
A 76-year-old man who had been diagnosed with long-QT syndrome type 2 had frequent syncopal attacks. The electrocardiogram was monitored, and frequent torsades de pointes (TdP) was detected despite administration of conventional medications: oral propranolol, verapamil, intravenous magnesium sulfate, verapamil, and lidocaine. In contrast, 2 μg/kg/min landiolol could completely suppress TdP. Subsequently, an implantable cardioverter defibrillator was placed, and he was diagnosed with silent myocardial ischemia using myocardial perfusion scintigraphy and coronary angiography...
October 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29016765/broad-antiarrhythmic-effect-of-mexiletine-in-different-arrhythmia-models
#17
Gerrit Frommeyer, Jonas Garthmann, Christian Ellermann, Dirk G Dechering, Simon Kochhäuser, Florian Reinke, Julia Köbe, Kristina Wasmer, Lars Eckardt
Aims: Experimental studies and clinical reports suggest antiarrhythmic properties of mexiletine in different arrhythmias. We aimed at investigating mexiletine in experimental models of atrial fibrillation (AF) as well as in long-QT- (LQTS) and short-QT-syndrome (SQTS). Methods and results: In 15 isolated rabbit hearts, erythromycin (300 µM) was infused for simulation of long-QT-2-syndrome. In further 13 hearts, veratridine was administered to simulate long-QT-3-syndrome...
August 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28964110/a-model-of-cardiac-ryanodine-receptor-gating-predicts-experimental-ca-2-dynamics-and-ca-2-triggered-arrhythmia-in-the-long-qt-syndrome
#18
Dan Wilson, Bard Ermentrout, Jan Němec, Guy Salama
Abnormal Ca(2+) handling is well-established as the trigger of cardiac arrhythmia in catecholaminergic polymorphic ventricular tachycardia and digoxin toxicity, but its role remains controversial in Torsade de Pointes (TdP), the arrhythmia associated with the long QT syndrome (LQTS). Recent experimental results show that early afterdepolarizations (EADs) that initiate TdP are caused by spontaneous (non-voltage-triggered) Ca(2+) release from Ca(2+)-overloaded sarcoplasmic reticulum (SR) rather than the activation of the L-type Ca(2+)-channel window current...
September 2017: Chaos
https://www.readbyqxmd.com/read/28963955/structural-investigation-of-vesnarinone-at-the-pore-domains-of-open-and-open-inactivated-states-of-herg1-k-channel
#19
Gülru Kayık, Nurcan Ş Tüzün, Serdar Durdagi
In this study, the dynamics of vesnarinone bounded hERG1 K(+) channels are investigated using in silico approaches such as molecular docking, molecular dynamics (MD) simulations, MM/PBSA (Molecular Mechanics/Poisson Boltzmann Surface Area) calculations and Principal Component Analysis (PCA). Vesnarinone (a cardiotonic agent) falls into a category of drugs that inhibit phosphodiesterase 3-type (PDE3) enzymes. PDE3 enzymes have specific roles in the dehydyrolysis of intracellular second messengers 3',5'-cyclic adenosine monophosphate (cAMP) and 3',5'-cyclic guanosine monophosphate (cGMP)...
September 6, 2017: Journal of Molecular Graphics & Modelling
https://www.readbyqxmd.com/read/28955244/human-in-silico-drug-trials-demonstrate-higher-accuracy-than-animal-models-in-predicting-clinical-pro-arrhythmic-cardiotoxicity
#20
Elisa Passini, Oliver J Britton, Hua Rong Lu, Jutta Rohrbacher, An N Hermans, David J Gallacher, Robert J H Greig, Alfonso Bueno-Orovio, Blanca Rodriguez
Early prediction of cardiotoxicity is critical for drug development. Current animal models raise ethical and translational questions, and have limited accuracy in clinical risk prediction. Human-based computer models constitute a fast, cheap and potentially effective alternative to experimental assays, also facilitating translation to human. Key challenges include consideration of inter-cellular variability in drug responses and integration of computational and experimental methods in safety pharmacology. Our aim is to evaluate the ability of in silico drug trials in populations of human action potential (AP) models to predict clinical risk of drug-induced arrhythmias based on ion channel information, and to compare simulation results against experimental assays commonly used for drug testing...
2017: Frontiers in Physiology
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