Document Detail


Baseline values and sotalol-induced changes of ventricular repolarization duration, heterogeneity, and instability in patients with a history of drug-induced torsades de pointes.
MedLine Citation:
PMID:  18957528     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The authors investigated whether computerized parameters quantifying ventricular repolarization delay, heterogeneity, and instability characterize individuals who developed drug-induced Torsades de Pointes. Assessing an individual's propensity to Torsades de Pointes when exposed to a QT-prolonging drug is challenging because baseline QT prolongation has limited predictive value. Five-minute digital 12-lead electrocardiograms were acquired at baseline and after a sotalol challenge in 16 patients who had a history of Torsades de Pointes in the context of a QT-prolonging drug and 17 patients who did not have such history. Computerized measurements of QTc, T peak to T end intervals (TpTe), TpTe/QTc, and QT variability were implemented, and novel quantifiers of ventricular repolarization heterogeneity from the early (ERD) and late (LRD) part of the T wave were investigated. Compared with electrocardiograms of patients without a history of Torsades de Pointes, the baseline electrocardiograms of patients with a history of Torsades de Pointes had a longer QTc and an increased repolarization heterogeneity of the early part of the T wave (ERD30%: 44 +/- 13 vs 35 +/- 8 ms, P = .02). On sotalol, the electrocardiograms from individuals with Torsades de Pointes revealed a delay of the terminal part of the T wave that was not present in patients without Torsades de Pointes (TpTe: 27 +/- 40 vs -2 +/- 21 ms, P = .02; LRD70%: 20 +/- 29 vs 2 +/- 4 ms, P = .04). Results suggest that the electrocardiogram abnormalities characterizing patients with a history of Torsades de Pointes are (1) an increased repolarization heterogeneity at baseline and (2) a sotalol-induced prolongation of the terminal part of the T wave.
Authors:
Jean-Philippe Couderc; Stefan Kaab; Martin Hinterseer; Scott McNitt; Xiaojuan Xia; Anthony Fossa; Britt M Beckmann; Slava Polonsky; Wojciech Zareba
Related Documents :
9266578 - Pharmacologic therapy of asthma during pregnancy.
1326358 - Establishment of a liaison service for pregnant opiate-dependent women.
7632538 - Recognition and management of angiotensin converting enzyme inhibitor fetopathy.
7759168 - Substance use during pregnancy and peripartum complications in a triethnic population.
6650598 - Plasma 11-deoxycortisol in normal and abnormal human pregnancy.
22515548 - "double trouble" or an amplification of the triploidy phenotype?
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-10-28
Journal Detail:
Title:  Journal of clinical pharmacology     Volume:  49     ISSN:  0091-2700     ISO Abbreviation:  J Clin Pharmacol     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-31     Completed Date:  2009-02-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0366372     Medline TA:  J Clin Pharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  6-16     Citation Subset:  IM    
Affiliation:
Heart Research Follow-Up Program, Cardiology Department, University of Rochester Medical Center, Rochester, NY 14642, USA. jean-philippe.couderc@heart.rochester.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Anti-Arrhythmia Agents / adverse effects*
Electrocardiography
Female
Humans
Male
Middle Aged
Sotalol / adverse effects*
Torsades de Pointes / chemically induced,  physiopathology*
Ventricular Dysfunction / chemically induced,  physiopathology*
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 3930-20-9/Sotalol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Immediate active range of motion after modified 2-incision repair in acute distal biceps tendon rupt...
Next Document:  Circulating levels of resistin and risk of type 2 diabetes in men and women: results from two prospe...