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https://www.readbyqxmd.com/read/28220940/pharmacologic-conversion-during-dofetilide-treatment-for-persistent-atrial-fibrillation
#1
Jonathan S Steinberg, Yash Shah, Barbara Szepietowska
BACKGROUND: Dofetilide is a pure IKr blocker and is one of the few drugs specifically studied and approved in the United States for the management of persistent AF. Dofetilide has been noted to have a high rate of pharmacologic conversion during initial dosing in prior smaller studies. The intent of the study was to examine the safety of an inpatient loading strategy, and the incidence and patterns of pharmacologic conversion by dofetilide during the treatment of persistent AF in a large consecutive cohort...
February 21, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28213480/a-common-genetic-variant-risk-score-is-associated-with-drug-induced-qt-prolongation-and-torsade-de-pointes-risk-a-pilot-study
#2
David G Strauss, Jose Vicente, Lars Johannesen, Ksenia Blinova, Jay W Mason, Peter Weeke, Elijah R Behr, Dan M Roden, Raymond Woosley, Gulum Kosova, Michael A Rosenberg, Christopher Newton-Cheh
Background -Drug-induced QT interval prolongation, a risk factor for life-threatening ventricular arrhythmias, is a potential side effect of many marketed and withdrawn medications. The contribution of common genetic variants previously associated with baseline QT interval to drug-induced QT prolongation and arrhythmias is not known. Methods -We tested the hypothesis that a weighted combination of common genetic variants contributing to QT interval at baseline, identified through genome-wide association studies, can predict individual response to multiple QT-prolonging drugs...
February 17, 2017: Circulation
https://www.readbyqxmd.com/read/28213055/electrophysiological-measurements-that-can-explain-and-guide-temporary-accelerated-pacing-to-avert-re-occurrence-of-torsade-de-pointes-arrhythmias-in-the-canine-chronic-atrioventricular-block-model
#3
Sofieke C Wijers, Alexandre Bossu, Albert Dunnink, Jet D M Beekman, Rosanne Varkevisser, Alfonso Aranda Hernández, Mathias Meine, Marc A Vos
BACKGROUND: Pacing at higher rates is known to suppress Torsade de Pointes (TdP) arrhythmias. Nevertheless, exact application and mechanism need further clarification. In the anesthetized, canine, chronic atrioventricular block model, ventricular remodeling is responsible for a high and reproducible incidence of TdP upon a challenge with dofetilide. OBJECTIVE: We used this model to investigate by what mechanism accelerated pacing averts TdP and what repolarization parameter could be used to guide temporary applied accelerated pacing (TAP)...
February 14, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28202629/improving-the-in-silico-assessment-of-proarrhythmia-risk-by-combining-herg-human-ether-%C3%A3-go-go-related-gene-channel-drug-binding-kinetics-and-multichannel-pharmacology
#4
Zhihua Li, Sara Dutta, Jiansong Sheng, Phu N Tran, Wendy Wu, Kelly Chang, Thembi Mdluli, David G Strauss, Thomas Colatsky
BACKGROUND: The current proarrhythmia safety testing paradigm, although highly efficient in preventing new torsadogenic drugs from entering the market, has important limitations that can restrict the development and use of valuable new therapeutics. The CiPA (Comprehensive in vitro Proarrhythmia Assay) proposes to overcome these limitations by evaluating drug effects on multiple cardiac ion channels in vitro and using these data in a predictive in silico model of the adult human ventricular myocyte...
February 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28202194/study-of-factors-affecting-the-progression-and-termination-of-drug-induced-torsade-de-pointes-in-two-dimensional-cardiac-tissue
#5
Ponnuraj Kirthi Priya, M Ramasubba Reddy
INTRODUCTION: To study the conditions leading to the initiation and termination of drug induced Torsade de pointes (TdP) along with QT prolongation. METHODS: A 2D anisotropic transmural section of the ventricular myocardium is modeled using the TP06 equations and the cells are interconnected with gap junction conductances (GJC). The tissue is remodeled by reducing the repolarization reserve (by increasing calcium current (ICaL)) of all cells thus making them vulnerable to development of early after depolarizations (EADs)...
February 2, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28188930/microrna-135a-regulates-sodium-calcium-exchanger-gene-expression-and-cardiac-electrical-activity
#6
Eric Duong, Jiening Xiao, Xiao Yan Qi, Stanley Nattel
BACKGROUND: Complete atrioventricular block (CAVB) causes arrhythmogenic remodeling and increases the risk of Torsades de Pointes (TdP) arrhythmias. MicroRNAs (miRNAs) are key regulators of gene-expression that contribute to cardiac remodeling. OBJECTIVE: To assess miRNA changes after complete atrioventricular block (CAVB) and identify novel candidates potentially involved in arrhythmogenic cardiac remodeling. METHODS: CAVB was induced in mice via His bundle ablation...
February 7, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28186837/methadone-and-corrected-qt-prolongation-in-pain-and-palliative-care-patients-a-case-control-study
#7
Katherine M Juba, Tina M Khadem, David J Hutchinson, Jack E Brown
BACKGROUND: Methadone (ME) is commonly used in pain and palliative care (PPC) patients with refractory pain or intolerable opioid adverse effects (AEs). A unique ME AE is its corrected QT (QTc) interval prolongation risk, but most evidence exists in methadone maintenance therapy patients. OBJECTIVE: Our goal was to identify QTc interval prolongation risk factors in PPC patients receiving ME and other medications known to prolong the QTc interval and develop a risk stratification tool...
February 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28185059/severe-proarrhythmic-potential-of-the-antiemetic-agents-ondansetron-and-domperidone
#8
Gerrit Frommeyer, Christina Fischer, Christian Ellermann, Philipp S Lange, Dirk G Dechering, Simon Kochhäuser, Michael Fehr, Lars Eckardt
The potential of ondansetron and domperidone, both clinically established antiemetic agents, to increase the QT-interval has been described in several case reports. Therefore, the aim of the present study was to investigate whether these drugs may provoke polymorphic ventricular tachycardia in a sensitive experimental model of drug-induced proarrhythmia. In 10 female rabbits, ondansetron (1, 5 and 10 µM, n = 10) or domperidone (0.5, 1 and 2 µM, n = 8) was infused after obtaining baseline data. Eight endo- and epicardial monophasic action potentials and a simultaneously recorded 12-lead ECG reproduced the clinically observed QT-prolongation (ondansetron: 1 µM:+17 ms, 5 µM:+41 ms, 10 µM:+78 ms, p < 0...
February 9, 2017: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/28137545/delayed-normalization-of-electrocardiograms-in-patients-with-takotsubo-cardiomyopathy-due-to-aneurysmal-subarachnoid-hemorrhage
#9
Keisuke Kadooka, Hiromu Hadeishi, Kosuke Kadooka
BACKGROUND: Takotsubo cardiomyopathy (TCM) is caused by excessive physical and mental stress, and sometimes causes potentially fatal arrhythmias such as torsades de pointes. This study characterized the features of TCM due to aneurysmal subarachnoid hemorrhage (SAH), particularly the delayed normalization of electrocardiograms compared to that of transthoracic echocardiograms. METHODS: Ten patients with TCM were selected from the 450 SAH patients treated in our hospital between January 2007 and November 2015...
January 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28132684/an-18-year-old-woman-who-was-found-down
#10
Mazen M Kawji, David Luke Glancy
An 18-year-old woman was found unresponsive by her mother. After the patient spontaneously regained consciousness, an electrocardiogram showed a markedly prolonged QT interval thought to be due to congenital long QT1. An implantable cardioverter defibrillator was placed. After being free of symptoms for 1 year, she spontaneously developed torsades de pointes that was successfully terminated by the defibrillator.
January 6, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28127218/recurrent-takotsubo-with-prolonged-qt-and-torsade-de-pointes-and-left-ventricular-thrombus
#11
REVIEW
Alaa Eldin K Ahmed, Abdulhalim Serafi, Nadia S Sunni, Hussein Younes, Walid Hassan
Takotsubo cardiomyopathy, also known as "takotsubo syndrome," refers to transient apical ballooning syndrome, stress cardiomyopathy, or broken heart syndrome and is a recently recognized syndrome typically characterized by transient and reversible left ventricular dysfunction that develops in the setting of acute severe emotional or physical stress. Increased catecholamine levels have been proposed to play a central role in the pathogenesis of the disease, although the specific pathophysiology of this condition remains to be fully determined...
January 2017: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/28109524/torsades-de-pointes-with-high-dose-loperamide
#12
Patrick M Kozak, Amanda K Harris, John A McPherson, Dan M Roden
CASE: A 41year-old male presented with torsades de pointes. The patient was taking over 100mg of loperamide per day to self-medicate for chronic pain. Coronary angiography, cardiac magnetic resonance imaging, and genetic testing were negative for pre-disposing ischemia, cardiomyopathy, or genetic variant respectively. CONCLUSIONS: Patients without predisposing genetic or cardiac abnormalities are at risk of life-threatening QTc prolongation and torsades with use of high-dose loperamide...
January 16, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28100427/the-possible-role-of-propofol-in-drug-induced-torsades-de-pointes-a-real-world-single-center-analysis
#13
Victor A Abrich, Harish Ramakrishna, Arjun Mehta, Farouk Mookadam, Komandoor Srivathsan
BACKGROUND: Torsades de pointes (TdP) is a polymorphic ventricular tachycardia associated with QT prolongation. Propofol is a sedative-anesthetic with proarrhythmic effects on cardiac myocytes. We performed a retrospective study to determine the incidence of TdP following propofol exposure at Mayo Clinic (Rochester, MN) from 08/11/1998-11/20/2015. METHODS: We queried our database using key search terms to identify patients exposed to propofol who developed TdP perioperatively or during non-surgical sedation...
January 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28073687/adverse-event-detection-using-the-fda-post-marketing-drug-safety-surveillance-system-cardiotoxicity-associated-with-loperamide-abuse-and-misuse
#14
Kimberley A Swank, Eileen Wu, Cindy Kortepeter, Jana McAninch, Robert L Levin
OBJECTIVE: The purpose of this investigation was to identify and characterize post-marketing reports of cardiotoxicity, including torsades de pointes (TdP), associated with loperamide use. METHODS: We searched the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database for post-marketing reports of serious cardiac adverse events associated with loperamide use from December 28, 1976 (U.S. drug approval date), through December 14, 2015. We also conducted a Pubmed and Google Scholar search to identify additional published reports of cardiotoxicity associated with loperamide in the medical literature through February 11, 2016...
January 7, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28062741/dextrose-hypokalemia-and-torsade-de-pointes
#15
Pankaj Mathur, Sushilkumar S Gupta, Rajeswer Sarasam, Vinod Namana
No abstract text is available yet for this article.
January 5, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28033168/is-cardiovascular-risk-a-concern-when-prescribing-azithromycin
#16
S Scott Sutton
The FDA has updated azithromycin package labeling to include the risk of prolonged cardiac repolarization and QT prolongation, which increase the possibility of cardiac dysrhythmias and torsades de pointes, especially in older adults. The update was initiated by a study that found an increased risk of death in patients taking azithromycin compared with those taking amoxicillin. However, cardiovascular results of other azithromycin studies have demonstrated discordant results, and more research is needed. In the meantime, providers should recognize that azithromycin has a role in the management of bacterial infections and should prescribe the antibiotic when warranted...
January 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28031851/a-good-excuse-for-skipping-the-test-electrical-storm-in-a-teenager
#17
Patrícia Rodrigues, António Pinheiro-Vieira, Marília Loureiro, Sílvia Álvares, Diana Anjo, Carla Roque, Maria João Sousa, Severo Torres
We describe the case of a teenager with a structurally normal heart that presented with torsades de pointes and cardiac arrest. He had a history of epilepsy in childhood, mild cognitive impairment and cognitive visual dysfunction. The baseline electrocardiogram had prominent J waves and a marked early repolarization pattern in all the leads, with normal QT interval. We discuss the differential diagnosis for this interesting case, as well as the patient's management.
December 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28019033/evidence-for-the-herg-liability-of-antihistamines-antipsychotics-and-anti-infective-agents-a-systematic-literature-review-from-the-aritmo-project
#18
REVIEW
Lorna Hazell, Emanuel Raschi, Fabrizio De Ponti, Simon H L Thomas, Francesco Salvo, Ernst Ahlberg Helgee, Scott Boyer, Miriam Sturkenboom, Saad Shakir
A systematic review was performed to categorize the hERG (human ether-a-go-go-related gene) liability of antihistamines, antipsychotics, and anti-infectives and to compare it with current clinical risk of torsade de pointes (TdP). Eligible studies were hERG assays reporting half-minimal inhibitory concentrations (IC50). A "hERG safety margin" was calculated from the IC50 divided by the peak human plasma concentration (free Cmax ). A margin below 30 defined hERG liability. Each drug was assigned an "uncertainty score" based on volume, consistency, precision, and internal and external validity of evidence...
December 26, 2016: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28018149/knowledge-gain-of-pharmacy-students-and-pharmacists-comparing-simulation-versus-traditional-learning-methodology
#19
Mary Grace Cravens, Kim Benner, Jennifer Beall, Mary Worthington, Brenda Denson, Amber Q Youngblood, J Lynn Zinkan, Nancy M Tofil
OBJECTIVES: The purpose of this study was to evaluate the difference between education via written materials alone and written materials enhanced with hands-on simulation. METHODS: A simulation case, educational module, and assessment regarding torsades de pointes (TdP) in an adolescent patient were designed. The written educational module was given to all study participants. A total of 92 third-year pharmacy students and 26 pharmacists participated in the study. RESULTS: When approximately half of the participants had been to simulation, an anonymous assessment was given...
November 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28012188/video-assisted-thoracoscopic-left-cardiac-sympathetic-denervation-in-patients-with-hereditary-ventricular-arrhythmias
#20
Se Yong Jang, Yongkeun Cho, Nam Kyun Kim, Chang-Yeon Kim, Jihyun Sohn, Jae-Hyung Roh, Myung Hwan Bae, Jang Hoon Lee, Dong Heon Yang, Hun Sik Park, Shung Chull Chae, Tak-Hyuk Oh, Gun Jik Kim
BACKGROUND: Left cardiac sympathetic denervation (LCSD) has been underutilized in patients with hereditary ventricular arrhythmia syndromes such as congenital long QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT). The purpose of this study was to investigate the safety and efficacy of video-assisted thoracoscopic (VATS) LCSD in such patients. METHODS: Fifteen patients (4 men, 24.6 ± 10.5 years old) who underwent VATS-LCSD between November 2010 and January 2015 for hereditary ventricular arrhythmia syndromes at Kyungpook National University Hospital were enrolled in this study...
December 24, 2016: Pacing and Clinical Electrophysiology: PACE
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