Investigation of the Potential of Clozapine to Cause Torsade de Pointes

2002 ◽  
Vol 21 (4) ◽  
pp. 189-203 ◽  
Author(s):  
Barbara Warner ◽  
Peter Hoffmann
Keyword(s):  
Torsade De Pointes

CME-EKG 66/Antworten: Torsade de pointes: die Gefahr der rotierenden Herzachse

Praxis ◽  
2020 ◽  
Vol 109 (13) ◽  
pp. 1035-1038
Author(s):  
Susanne Markendorf ◽  
Ardan M. Saguner ◽  
Corinna Brunckhorst
Keyword(s):  
Medikamentöse Therapie ◽  
Torsade De Pointes

Zusammenfassung. Die Torsade-de-pointes-Tachykardie ist eine maligne Herzrhythmusstörung, der eine Verlängerung des QT-Intervalls zugrunde liegt. Diese Verlängerung der QT-Zeit ist entweder angeboren oder erworben. Die erworbene Form wird meist durch medikamentöse Therapie verursacht. Die Torsade-de-pointes-Tachykardie ist durch einen stetigen Achsenwechsel und Undulation der QRS-Amplitude um die Grundlinie charakterisiert und meist selbstlimitierend. Dennoch kann sie in einigen Fällen auch in ein Kammerflimmern degenerieren und damit zum Herzkreislaufstillstand führen. Dieser Artikel soll einen Einblick in Ätiologie, Diagnostik, Prävention und Management dieser Herzrhythmusstörung geben.

Cardiac arrhythmias related to psychiatric medication

2017 ◽  
Vol 36 (09) ◽  
pp. 747-750
Author(s):  
R. W. Freudenmann ◽  
C. Schönfeldt-Lecuona ◽  
B. J. Connemann ◽  
M. Gahr ◽  
M. Elsayed
Keyword(s):  
Cardiac Arrhythmias ◽  
Torsade De Pointes ◽  
General Medicine ◽  
Fold Increase ◽  
Cardiac Risk ◽  
Psychiatric Medication ◽  
Cardiac Side Effects ◽  
Torsade De Pointes Tachycardia ◽  
Multiple Drugs ◽  
Available Information

SummaryThis narrative review summarizes current available information about cardiac arrhythmias (QT prolongation, Torsade de pointes Tachycardia [TdP], sudden cardiac death) associated with psychiatric medication. Among the most commonly used antipsychotics, amisulpride and ziprasidone are most frequently associated with TdP. Treatment with some antidepressants (SSRIs, tricyclic antidepressants) is associated with a 5- to 6-fold increase in the incidence of out-of-hospital cardiac arrest. Lithium is associated with bradycardia, T-wave changes and AV-block; anxiolytics of the benzodiazepine group do usually not have cardiac side effects. The combination of multiple drugs (including medications from general medicine) that prolong the QT interval has a particularly high cardiac risk.

Reproducible Induction of Early Afterdepolarizations and Torsade de Pointes Arrhythmias by d -Sotalol and Pacing in Dogs With Chronic Atrioventricular Block

Circulation ◽  
1995 ◽  
Vol 91 (3) ◽  
pp. 864-872 ◽  
Author(s):  
Marc A. Vos ◽  
S. Cora Verduyn ◽  
Anton P.M. Gorgels ◽  
Gyorgyi C. Lipcsei ◽  
Hein J.J. Wellens
Keyword(s):  
Atrioventricular Block ◽  
Torsade De Pointes ◽  
Early Afterdepolarizations

scholarly journals Catheter ablation of short-coupled variant of torsade de pointes

2021 ◽  
Author(s):  
Johannes Steinfurt ◽  
Babak Nazer ◽  
Martin Aguilar ◽  
Joshua Moss ◽  
Satoshi Higuchi ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Torsade De Pointes ◽  
Intracardiac Echocardiography ◽  
Long Term Results ◽  
Electrical Storm ◽  
3D Mapping ◽  
Free Wall ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy

Abstract Background The short-coupled variant of torsade de pointes (sc-TdP) is a malignant arrhythmia that frequently presents with ventricular fibrillation (VF) electrical storm. Verapamil is considered the first-line therapy of sc-TdP while catheter ablation is not widely adopted. The aim of this study was to determine the origin of sc-TdP and to assess the outcome of catheter ablation using 3D-mapping. Methods and results We retrospectively analyzed five patients with sc-TdP who underwent 3D-mapping and ablation of sc-TdP at five different institutions. Four patients initially presented with sudden cardiac arrest, one patient experienced recurrent syncope as the first manifestation. All patients demonstrated a monomorphic premature ventricular contraction (PVC) with late transition left bundle branch block pattern, superior axis, and a coupling interval of less than 300 ms. triggering recurrent TdP and VF. In four patients, the culprit PVC was mapped to the free wall insertion of the moderator band (MB) with a preceding Purkinje potential in two patients. Catheter ablation using 3D-mapping and intracardiac echocardiography eliminated sc-TdP in all patients, with no recurrence at mean 2.7 years (range 6 months to 8 years) of follow-up. Conclusion 3D-mapping and intracardiac echocardiography demonstrate that sc-TdP predominantly originates from the MB free wall insertion and its Purkinje network. Catheter ablation of the culprit PVC at the MB free wall junction leads to excellent short- and long-term results and should be considered as first-line therapy in recurrent sc-TdP or electrical storm. Graphic abstract

scholarly journals Syncope due to non-sustained episodes of Torsade de Pointes associated to androgen-deprivation therapy use: a case presentation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ximena Morales ◽  
Diego Garnica ◽  
Daniel Isaza ◽  
Nicolas Isaza ◽  
Felipe Durán-Torres
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Androgen Deprivation Therapy ◽  
Torsade De Pointes ◽  
Androgen Deprivation ◽  
Atrial Pacing ◽  
Case Presentation ◽  
Reduced Ejection Fraction ◽  
Artery Disease

Abstract Background Abiraterone is a medication frequently used for metastatic castrate-resistant prostate cancer. We report a case of non-sustained episodes of TdP associated with severe hypokalemia due to androgen-deprivation therapy. Few case presentations describe this association; the novelty lies in the potentially lethal cardiovascular events among cancer patients receiving hormonal therapy. Case presentation A 70-year-old male presented with recurrent syncope without prodrome. ECG revealed frequent ventricular ectopy, non-sustained episodes of TdP, and severe hypomagnesemia and hypokalemia. During potassium and magnesium infusion for repletion, the patient underwent temporary transvenous atrial pacing. As part of the work-up, coronary angiography revealed a mild coronary artery disease, and transthoracic echocardiogram showed a moderately depressed ejection fraction. After electrolyte disturbances were corrected, the QT interval normalized, and transvenous pacing was no longer necessary. Abiraterone was discontinued during the admission, and the patient returned to baseline. Conclusions Cancer treatment is complex and requires a multidisciplinary approach. We presented a case of non-sustained TdP associated with androgen-deprivation therapy in an elderly patient with mild coronary artery disease and moderately reduced ejection fraction. Close follow-up and increased awareness are required in patients with hormonal treatment, especially in the setting of other cardiovascular risk factors.

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