Article
Medicine, General & Internal
Sok-Sithikun Bun, Nathan Heme, Florian Asarisi, Fabien Squara, Didier Scarlatti, Pamela Moceri, Emile Ferrari
Summary: This study analyzed the clinical characteristics of patients with high-grade atrioventricular block (AVB) presenting with torsades de pointes (TdP), and found that the QTc(FR), JT, and Tpeak-to-end intervals were significantly prolonged in these patients.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Cardiac & Cardiovascular Systems
Zhilin Qu, James N. Weiss
Summary: Cardiac alternans is a result of instabilities in the electrical and calcium cycling systems of the heart, and can lead to ventricular arrhythmias and sudden cardiac death. This review integrates clinical observations, theory, and experiments to provide a comprehensive understanding of the underlying mechanisms, arrhythmic manifestations, and electrocardiographic signatures of cardiac alternans. The review summarizes the cellular and tissue mechanisms that have been demonstrated theoretically and experimentally, and discusses their relevance to different disease conditions and their impact on electrocardiographic characteristics observed in patients. The main conclusion is that alternans is not only a predictor but also a causal mechanism of potentially lethal ventricular and atrial arrhythmias across a wide range of arrhythmia mechanisms.
CIRCULATION RESEARCH
(2023)
Review
Medicine, General & Internal
Annette Wacker-Gussmann, Gretchen K. Eckstein, Janette F. Strasburger
Summary: The number of women diagnosed with ion channelopathy in childhood and effectively treated using beta blockers, sympathectomy, and cardiac pacemakers/defibrillators is increasing. Offspring of these women have a 50% risk of inheriting the disease, necessitating complex delivery room preparation in pregnancies with inherited arrhythmia syndromes. Fetal magnetocardiography now allows for the detection of various arrhythmias in susceptible fetuses, requiring specialists to have optimal knowledge and equipment for the care of these specialized pregnancies.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Toxicology
Jean-Pierre Valentin, Peter Hoffmann, Catherine Ortemann-Renon, John Koerner, Jennifer Pierson, Gary Gintant, James Willard, Christine Garnett, Matthew Skinner, Hugo M. Vargas, Todd Wisialowski, Michael K. Pugsley
Summary: This article compares the concordance between nonclinical repolarization assays and the clinical thorough QT (TQT) study and explores the mechanisms that may cause discrepancies. The study finds that although nonclinical assays have good specificity in predicting negative clinical QT prolongation, they have relatively poor sensitivity in predicting positive clinical QT prolongation. The article also provides an overview of mechanisms responsible for QT prolongation and outlines some best practices.
TOXICOLOGICAL SCIENCES
(2022)
Article
Cardiac & Cardiovascular Systems
Sami Viskin, Ehud Chorin, Arie Lorin Schwartz, Piotr Kukla, Raphael Rosso
Summary: Cardiac memory is an interesting electrocardiographic phenomenon where T waves become abnormal in the opposite direction of wide QRS complex, and normalize at a later stage. Reduction of repolarizing potassium currents during cardiac memory may lead to prolonged QT syndrome and ventricular arrhythmias.
Article
Cardiac & Cardiovascular Systems
Tyler Gallo, C. William Heise, Raymond L. Woosley, James E. Tisdale, Malinda S. Tan, Sheila M. Gephart, Corneliu C. Antonescu, Daniel C. Malone
Summary: This study evaluated the actions taken by clinicians in response to a CDS advisory that used a modified Tisdale QT risk score and offered easily selected management options. The results showed that the system was effective in guiding clinicians to take appropriate measures for medications with potential TdP risk, with ordering an ECG being the most frequent action taken.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2022)
Article
Pharmacology & Pharmacy
Xuechun Mu, Yujiao Duan, Qiuhua Xu, Sa Wang, Guiju Gao, Ning Han, Hongxin Zhao
Summary: With the increasing life expectancy of HIV patients, there is growing concern about the potential toxicity and drug interactions of long-term antiretroviral therapy. This article describes a female patient with HIV who experienced loss of consciousness after taking both antiretroviral therapy and terfenadine.
FRONTIERS IN PHARMACOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Edi Prifti, Ahmad Fall, Giovanni Davogustto, Alfredo Pulini, Isabelle Denjoy, Christian Funck-Brentano, Yasmin Khan, Alexandre Durand-Salmon, Fabio Badilini, Quinn S. Wells, Antoine Leenhardt, Jean-Daniel Zucker, Dan M. Roden, Fabrice Extramiana, Joe-Elie Salem
Summary: The study aimed to enhance the prediction of drug-induced TdP and diagnosis of cLQTS using convolutional neural network models analyzing ECG alterations induced by sotalol. The CNN models outperformed QTc measurements and were particularly effective shortly after a diTdP episode.
EUROPEAN HEART JOURNAL
(2021)
Article
Cardiac & Cardiovascular Systems
Mathilde R. Rivaud, Jason D. Bayer, Matthijs Cluitmans, Jeanne van der Waal, Laura R. Bear, Bastiaan J. Boukens, Charly Belterman, Lisa Gottlieb, Fanny Vaillant, Emma Abell, Remi Dubois, Veronique M. F. Meijborg, Ruben Coronel
Summary: The study found that torsades de pointes arrhythmia can be induced within a critical range of repolarization time and repolarization time heterogeneities, maintained by reentry wandering along the repolarization gradient. Local restitution curves from the long and short repolarization time regions crossed, associated with T wave inversion at coupling intervals at either side of the crossing point.
Article
Anesthesiology
Andrew Schaar, Mark Liu, Michael Patzkowski
Summary: This case study highlights the potential severe electrolyte derangements and long QT syndrome complications that can arise after a common outpatient procedure, emphasizing the importance of prompt diagnosis and appropriate treatment in preventing detrimental outcomes.
BMC ANESTHESIOLOGY
(2021)
Article
Public, Environmental & Occupational Health
Richard L. Morrow, Barbara Mintzes, Patrick C. Souverein, Christine E. Hallgreen, Bilal Ahmed, Elizabeth E. Roughead, Marie L. De Bruin, Sarah Brogger Kristiansen, Joel Lexchin, Anna Kemp-Casey, Ingrid Sketris, Dee Mangin, Sallie-Anne Pearson, Lorri Puil, Ruth Lopert, Lisa Bero, Danijela Gnjidic, Ameet Sarpatwari, Colin R. Dormuth
Summary: A longitudinal study showed that hydroxyzine initiation decreased in the UK after the safety advisories, but remained unchanged in British Columbia, Canada.
Review
Biochemistry & Molecular Biology
Daniela Baracaldo-Santamaria, Kevin Llinas-Caballero, Julian Miguel Corso-Ramirez, Carlos Martin Restrepo, Camilo Alberto Dominguez-Dominguez, Dora Janeth Fonseca-Mendoza, Carlos Alberto Calderon-Ospina
Summary: Long QT syndromes can be acquired or congenital, and drugs are a known risk factor for inducing acquired long QT syndrome. Despite common molecular mechanisms involved in QT interval prolongation, there is considerable inter-individual variability in drug response, emphasizing the importance of personalized medicine in evaluating the risk of each individual.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Review
Medicine, General & Internal
Simranjit S. Kahlon, Rabia Sikandar, Sreedevi Tejovath, Shaalina Nair, Danial Hassan, Khushbu K. Patel, Aishwarya Peddemul, Jihan A. Mostafa
Summary: TdP is a rare form of tachyarrhythmia that tends to degenerate into ventricular fibrillation, mainly occurring in patients with prolonged QT intervals, making it difficult to determine the significant risk factors. This study encourages further research into the implications of QT prolongation and how simple ECG monitoring and treatment can help save lives.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2022)
Article
Medicine, General & Internal
Irina Nordkin, Tatyana Levinas, Inna Rosenfeld, Majdi Halabi
Summary: Amiodarone should be avoided as a first-line therapy in patients without heart disease due to its potential to induce TdP. Careful monitoring of QT interval, particularly during intravenous administration, can help prevent the development of this life-threatening arrhythmia.
CLINICAL CASE REPORTS
(2021)
Article
Cardiac & Cardiovascular Systems
Thomas F. O'Connell, Christopher J. Bradley, Amr E. Abbas, Brian D. Williamson, Akash Rusia, Adam M. Tawney, Rick Gaines, Jason Schott, Alex Dmitrienko, David E. Haines
Summary: This study characterized QTc prolongation in hospitalized COVID-19 patients treated with HCQ/AZM. Several clinical factors were associated with greater QTc prolongation, but changes in QTc were not linked to increased risk of death.
JACC-CLINICAL ELECTROPHYSIOLOGY
(2021)