Should We be Worried About QTc Prolongation Using Citalopram? A Review

2016 ◽  
Vol 30 (3) ◽  
pp. 353-358 ◽  
Author(s):  
Lauren M. J. Hutton ◽  
Andrew J. Cave ◽  
Renée St-Jean ◽  
Hoan Linh Banh
Keyword(s):  
Risk Factors ◽  
Long Qt Syndrome ◽  
Causal Link ◽  
Clinical Impact ◽  
Patient Specific ◽  
Qtc Interval ◽  
Qtc Prolongation ◽  
Long Qt ◽  
Specific Risk ◽  
Qt Syndrome

Purpose: Summarize available information regarding clinical impact of citalopram on the QTc interval. Methods: A literature search was conducted in Pubmed, EMBASE, and Cochrane databases using the MeSH term “long QT syndrome” and key word “citalopram” on July 11, 2014. Results: Thirty-one studies were evaluated with 4 included in this review. Studies were excluded if they reported acute overdoses of citalopram or did not report on patient-specific risk factors for long QT syndrome (eg, hypokalemia, bradycardia, and increased age). The majority of the available data is derived from case reports. A number of confounders complicate the determination of a causal link between QTc prolongation and citalopram. Of the 4 studies included for review, none identified significant QTc prolongation in patients taking citalopram 20 to 60 mg daily without the patients having one or more patient-specific risk factors for prolonged QTc. Conclusion: There is insufficient evidence to establish a causal link between citalopram 20 to 60 mg orally daily and increased risk of TdP. Further research is required to determine the clinical impact and association between citalopram 20 to 60 mg daily and QTc prolongation.

scholarly journals TRIGGER-SPECIFIC RISK FACTORS FOR CARDIAC EVENTS IN PATIENTS WITH THE CONGENITAL LONG-QT SYNDROME TYPE 2

2010 ◽  
Vol 55 (10) ◽  
pp. A130.E1215
Author(s):  
James A. Kim ◽  
Arthur J. Moss ◽  
Coeli M. Lopes ◽  
Scott McNitt ◽  
Jennifer L. Robinson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Long Qt Syndrome ◽  
Syndrome Type ◽  
Cardiac Events ◽  
Long Qt ◽  
Specific Risk ◽  
Qt Syndrome ◽  
Congenital Long Qt Syndrome

scholarly journals Mechanisms, Risk Factors, and Management of Acquired Long QT Syndrome: A Comprehensive Review

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Eleftherios M. Kallergis ◽  
Christos A. Goudis ◽  
Emmanuel N. Simantirakis ◽  
George E. Kochiadakis ◽  
Panos E. Vardas
Keyword(s):  
Risk Factors ◽  
Long Qt Syndrome ◽  
Polymorphic Ventricular Tachycardia ◽  
Qtc Interval ◽  
Environmental Stressor ◽  
Long Qt ◽  
Acquired Long Qt Syndrome ◽  
Number Of Patients ◽  
Long Term Treatment ◽  
Qt Syndrome

Long QT syndrome is characterized by prolongation of the corrected QT (QTc) interval on the surface electrocardiogram and is associated with precipitation of torsade de pointes (TdP), a polymorphic ventricular tachycardia that may cause sudden death. Acquired long QT syndrome describes pathologic excessive prolongation of the QT interval, upon exposure to an environmental stressor, with reversion back to normal following removal of the stressor. The most common environmental stressor in acquired long QT syndrome is drug therapy. Acquired long QT syndrome is an important issue for clinicians and a significant public health problem concerning the large number of drugs with this adverse effect with a potentially fatal outcome, the large number of patients exposed to these drugs, and our inability to predict the risk for a given individual. In this paper, we focus on mechanisms underlying QT prolongation, risk factors for torsades de pointes and describe the short- and long-term treatment of acquired long QT syndrome.

scholarly journals Trigger-specific risk factors and response to therapy in long QT syndrome type 2

Heart Rhythm ◽  
2010 ◽  
Vol 7 (12) ◽  
pp. 1797-1805 ◽  
Author(s):  
James A. Kim ◽  
Coeli M. Lopes ◽  
Arthur J. Moss ◽  
Scott McNitt ◽  
Alon Barsheshet ◽  
...  
Keyword(s):  
Risk Factors ◽  
Long Qt Syndrome ◽  
Response To Therapy ◽  
Syndrome Type ◽  
Long Qt ◽  
Specific Risk ◽  
Qt Syndrome

Abstract 223: A Case for Hypoxia and Long QT Syndrome in Sudden Infant Death Syndrome

2012 ◽  
Vol 111 (suppl_1) ◽  
Author(s):  
Marianne Neary ◽  
Timothy J Mohun ◽  
Ross A Breckenridge
Keyword(s):  
Risk Factors ◽  
Heart Rate ◽  
Sudden Death ◽  
Long Qt Syndrome ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Qtc Interval ◽  
Long Qt ◽  
Qt Syndrome ◽  
Ecg Morphology

INTRODUCTION: Long QT syndrome is considered an important factor in the pathogenesis of Sudden Infant Death Syndrome (SIDS). Prolonged QTc intervals (c=corrected for heart rate) in SIDS are sometimes caused by mutations in genes encoding ion channels. Other causes remain largely idiopathic. HYPOTHESIS: Risk factors for SIDS, including maternal bed sharing, head covering and high altitude, are associated with a reduced oxygen environment. Our studies investigate a link between hypoxia and long QT syndrome in the neonate. METHODS: We characterised, for the first time, changes in the murine neonatal electrocardiogram (ECG) at: 0, 1, 3, 6, 12, 24 hours (n=12) and 2, 6 and 10 days (n=25) after birth. We investigated whether birth into hypoxia 10% O2 (n=16) and genetically elevating cardiac hypoxic signalling in neonatal mice alters the course of changes in ECG morphology (n=14). We analysed the ECG for heart rate and parameters associated with dysrrhythmia and sudden death, including the QTc interval. RESULTS: In the hours and days following birth, we observed a steady increase in heart rate (p<0.0001) and decrease in QTc interval (p<0.05). When neonates were raised in hypoxia for 24 hours, the trends in heart rate (p<0.001) and QTc interval (p<0.0001) were abolished and risk of neonatal death was 52% (17 out of 33) over 24 hours. In transgenic neonatal mice with elevated cardiac hypoxic signalling, we observed a significant bradycardia (p<0.0001) and elongated QTc interval (p<0.0001) compared to controls at ten days after birth, with death occurring pre-weaning. >CONCLUSIONS: Following birth there are significant changes in ECG morphology, including an increase in heart rate and decrease in QTc interval. Hypoxia diminishes these changes resulting in bradycardia and elongated QTc intervals. We hypothesise that the increase in ambient oxygen concentration after birth drives the maturation of cardiac electrical conduction, failure of which predisposes to dysrhythmia and sudden death. This is consistent with known risk factors of SIDS and provides a link between neonatal hypoxia and ECG repolarisation abnormalities.

scholarly journals Elucidating arrhythmogenic mechanisms of long-QT syndrome CALM1-F142L mutation in patient-specific induced pluripotent stem cell-derived cardiomyocytes

2017 ◽  
Vol 113 (5) ◽  
pp. 531-541 ◽  
Author(s):  
Marcella Rocchetti ◽  
Luca Sala ◽  
Lisa Dreizehnter ◽  
Lia Crotti ◽  
Daniel Sinnecker ◽  
...  
Keyword(s):  
Stem Cell ◽  
Long Qt Syndrome ◽  
Pluripotent Stem Cell ◽  
Induced Pluripotent Stem Cell ◽  
Patient Specific ◽  
Long Qt ◽  
Qt Syndrome ◽  
Induced Pluripotent

scholarly journals Patient-Specific Induced Pluripotent Stem-Cell Models for Long-QT Syndrome

2010 ◽  
Vol 363 (15) ◽  
pp. 1397-1409 ◽  
Author(s):  
Alessandra Moretti ◽  
Milena Bellin ◽  
Andrea Welling ◽  
Christian Billy Jung ◽  
Jason T. Lam ◽  
...  
Keyword(s):  
Stem Cell ◽  
Long Qt Syndrome ◽  
Pluripotent Stem Cell ◽  
Induced Pluripotent Stem Cell ◽  
Patient Specific ◽  
Cell Models ◽  
Long Qt ◽  
Qt Syndrome ◽  
Induced Pluripotent ◽  
Stem Cell Models

scholarly journals Paediatric/young versus adult patients with long QT syndrome

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001671
Author(s):  
Sharen Lee ◽  
Jiandong Zhou ◽  
Kamalan Jeevaratnam ◽  
Wing Tak Wong ◽  
Ian Chi Kei Wong ◽  
...  
Keyword(s):  
Long Qt Syndrome ◽  
Primary Outcome ◽  
Population Based ◽  
Public Hospitals ◽  
Qtc Interval ◽  
Onset Age ◽  
Long Qt ◽  
History Of ◽  
Qt Syndrome ◽  
Random Survival Forest

IntroductionLong QT syndrome (LQTS) is a less prevalent cardiac ion channelopathy than Brugada syndrome in Asia. The present study compared the outcomes between paediatric/young and adult LQTS patients.MethodsThis was a population-based retrospective cohort study of consecutive patients diagnosed with LQTS attending public hospitals in Hong Kong. The primary outcome was spontaneous ventricular tachycardia/ventricular fibrillation (VT/VF).ResultsA total of 142 LQTS (mean onset age=27±23 years old) were included. Arrhythmias other than VT/VF (HR 4.67, 95% CI (1.53 to 14.3), p=0.007), initial VT/VF (HR=3.25 (95% CI 1.29 to 8.16), p=0.012) and Schwartz score (HR=1.90 (95% CI 1.11 to 3.26), p=0.020) were predictive of the primary outcome for the overall cohort, while arrhythmias other than VT/VF (HR=5.41 (95% CI 1.36 to 21.4), p=0.016) and Schwartz score (HR=4.67 (95% CI 1.48 to 14.7), p=0.009) were predictive for the adult subgroup (>25 years old; n=58). A random survival forest model identified initial VT/VF, Schwartz score, initial QTc interval, family history of LQTS, initially asymptomatic and arrhythmias other than VT/VF as the most important variables for risk prediction.ConclusionClinical and ECG presentation varies between the paediatric/young and adult LQTS population. Machine learning models achieved more accurate VT/VF prediction.

scholarly journals Paediatric/young versus adult patients with long QT syndrome or catecholaminergic polymorphic ventricular tachycardia

2021 ◽  
Author(s):  
Sharen Lee ◽  
Jiandong Zhou ◽  
Kamalan Jeevaratnam ◽  
Wing Tak Wong ◽  
Ian Chi Kei Wong ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Long Qt Syndrome ◽  
Primary Outcome ◽  
Public Hospitals ◽  
Adult Patients ◽  
Polymorphic Ventricular Tachycardia ◽  
Qtc Interval ◽  
Long Qt ◽  
Old Patients ◽  
Qt Syndrome

AbstractIntroductionLong QT syndrome (LQTS) and catecholaminergic ventricular tachycardia (CPVT) are less prevalent cardiac ion channelopathies than Brugada syndrome in Asia. The present study compared paediatric/young and adult patients with these conditions.MethodsThis was a territory-wide retrospective cohort study of consecutive patients diagnosed with LQTS and CPVT attending public hospitals in Hong Kong. The primary outcome was spontaneous ventricular tachycardia/ventricular fibrillation (VT/VF).ResultsA total of 142 LQTS (mean onset age= 27±23 years old) and 16 CPVT (mean presentation age=11±4 years old) patients were included. For LQTS, arrhythmias other than VT/VF (HR=4.67, 95% confidence interval=[1.53-14.3], p=0.007), initial VT/VF (HR=3.25 [1.29-8.16], p=0.012) and Schwartz score (HR=1.90 [1.11-3.26], p=0.020) were predictive of the primary outcome for the overall cohort, whilst arrhythmias other than VT/VF (HR=5.41 [1.36-21.4], p=0.016) and Schwartz score (HR=4.67 [1.48-14.7], p=0.009) were predictive for the adult subgroup (>25 years old; n=58). All CPVT patients presented before the age of 25 but no significant predictors of VT/VF were identified. A random survival forest model identified initial VT/VF, Schwartz score, initial QTc interval, family history of LQTS, initially asymptomatic, and arrhythmias other than VT/VF as the most important variables for risk prediction in LQTS, and initial VT/VF/sudden cardiac death, palpitations, QTc, initially symptomatic and heart rate in CPVT.ConclusionClinical and ECG presentation vary between the pediatric/young and adult LQTS population. All CPVT patients presented before the age of 25. Machine learning models achieved more accurate VT/VF prediction.

scholarly journals Fever-induced QTc prolongation and ventricular arrhythmias in individuals with type 2 congenital long QT syndrome

2008 ◽  
Author(s):  
Ahmad S. Amin ◽  
Lucas J. Herfst ◽  
Brian P. Delisle ◽  
Christine A. Klemens ◽  
Martin B. Rook ◽  
...  
Keyword(s):  
Long Qt Syndrome ◽  
Ventricular Arrhythmias ◽  
Qtc Prolongation ◽  
Long Qt ◽  
Qt Syndrome ◽  
Congenital Long Qt Syndrome
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