Universität zu Köln

Michels, G., Kochanek, M. and Pfister, R. (2016). Life-threatening cardiac arrhythmias due to drug-induced QT prolongation A retrospective study over 6 years from a medical intensive care unit. Med. Klin.-Intensivmed Notfallmed., 111 (4). S. 302 - 310. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 2193-6226

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Abstract

Long QT syndrome (LQTS) can lead to ventricular arrhythmia, especially torsade de pointes (TdP) tachycardia and/or ventricular tachycardia (VT). The aim of this study is to characterize patients with life-threatening cardiac arrhythmias associated with drug-induced LQTS and to identify risk factors of distinct presenting arrhythmias. In this retrospective study, we present 33 consecutive cases of life-threatening cardiac arrhythmias associated with drug-induced long QT, which were direct admitted as emergency to a medical intensive care unit (MICU) during an observational time of 6 years. Of 33 identified cases, 55 % presented with TdP with the need of resuscitation and 45 % showed nonsustained VT, respectively. In the total cohort the mean corrected QT interval (QT(c)) was 532 +/- 29 ms, with 530 +/- 31 ms (n = 14) in men and 533 +/- 28 ms (n = 19) in women (p = 0.80), respectively. Cardiac drugs with QT(c) interval prolonging effect were reported in 24 % of cases, and the other 76 % involved noncardiac medications. Although hypokalemia is the most common risk factor for drug-induced malignant arrhythmias, a QT(c) interval of at least 500 ms seems to be the major determinant of the risk of drug-induced proarrhythmias. Interestingly, patients with TdP exhibit more bradycardia as such with VT. This is the first study of patients with drug-induced life-threatening cardiac arrhythmias who were admitted as a case of emergency to a MICU. Physicians should be aware of drug-induced LQTS and be able to identify patients at risk and avoid specific drugs in such patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Michels, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kochanek, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-276674
DOI:	10.1007/s00063-015-0071-6
Journal or Publication Title:	Med. Klin.-Intensivmed Notfallmed.
Volume:	111
Number:	4
Page Range:	S. 302 - 310
Date:	2016
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	2193-6226
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TORSADE-DE-POINTES; VENTRICULAR-TACHYCARDIA; RISK-FACTOR; INTERVAL; GENDER; BLOCK; REPOLARIZATION; MODULATION; MECHANISM Multiple languages Medicine, General & Internal Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27667