Acquired Long QT Syndrome: Frequency, Onset, and Risk Factors in Intensive Care Patients

2012 ◽  
Vol 32 (5) ◽  
pp. 32-41 ◽  
Author(s):  
Teri M. Kozik ◽  
Shu-Fen Wung
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Long Qt Syndrome ◽  
Retrospective Chart Review ◽  
Torsades De Pointes ◽  
Long Qt ◽  
Intensive Care Patients ◽  
Acquired Long Qt Syndrome ◽  
Qt Intervals ◽  
Qt Syndrome

Background Acquired long QT syndrome is a reversible condition that can lead to torsades de pointes and sudden cardiac death. Objective To determine the frequency, onset, frequency of medications, and risk factors for the syndrome in intensive care patients. Methods In a retrospective chart review of 88 subjects, hourly corrected QT intervals calculated by using the Bazett formula were collected. Acquired long QT syndrome was defined as a corrected QT of 500 milliseconds or longer or an increase in corrected QT of 60 milliseconds or greater from baseline level. Risk factors and medications administered were collected from patients’ medical records. Results The syndrome occurred in 46 patients (52%); mean time of onset was 7.4 hours (SD, 9.4) from time of admission. Among the 88 patients, 52 (59%) received a known QTc-prolonging medication. Among the 46 with the syndrome, 23 (50%) received a known QT-prolonging medication. No other risk factor studied was significantly predictive of the syndrome. Conclusions Acquired long QT syndrome occurs in patients not treated with a known QT-prolonging medication, indicating the importance of frequent QT monitoring of all intensive care patients.

scholarly journals Prolonged QTc: "Mind the Gap"

2014 ◽  
Vol 2 (1) ◽  
pp. 44-45
Author(s):  
Ahmad Mursel Anam ◽  
Raihan Rabbani ◽  
Farzana Shumy ◽  
M Mufizul Islam Polash ◽  
M Motiul Islam ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Long Qt Syndrome ◽  
Qt Interval ◽  
Torsades De Pointes ◽  
Junior Doctors ◽  
Long Qt ◽  
Acquired Long Qt Syndrome ◽  
Prolonged Qt Interval ◽  
Prolonged Qt ◽  
Qt Syndrome

We report a case of drug induced torsades de pointes, following acquired long QT syndrome. The patient got admitted for shock with acute abdomen. The initial prolonged QT-interval was missed, and a torsadogenic drug was introduced post-operatively. Patient developed torsades de pointes followed by cardiac arrest. She was managed well and discharged without complications. The clinical manifestations of long QT syndromes, syncope or cardiac arrest, result from torsades de pointes. As syncope or cardiac arrest have more common differential diagnoses, even the symptomatic long QT syndrome are commonly missed or misdiagnosed. In acquired long QT syndrome with no prior suggestive feature, it is not impossible to miss the prolonged QT-interval on the ECG tracing. We share our experience so that the clinicians, especially the junior doctors, will be more alert on checking the QT-interval even in asymptomatic patients. DOI: http://dx.doi.org/10.3329/bccj.v2i1.19970 Bangladesh Crit Care J March 2014; 2 (1): 44-45

A Candidate Locus Approach Identifies a Long QT Syndrome Gene Mutation

2003 ◽  
Vol 5 (2) ◽  
pp. 97-104 ◽  
Author(s):  
Theresa A. Beery ◽  
Macaira Dyment ◽  
Kerry Shooner ◽  
Timothy K. Knilans ◽  
D. Woodrow Benson
Keyword(s):  
Potassium Channel ◽  
Long Qt Syndrome ◽  
Family Members ◽  
Torsades De Pointes ◽  
Sudden Onset ◽  
Coding Region ◽  
Long Qt ◽  
Candidate Locus ◽  
Qt Intervals ◽  
Qt Syndrome

Long QT syndrome is an inherited disorder that results in lengthened cardiac repolarization. It can lead to sudden onset of torsades de pointes, ventricular fibrillation, and death. The authors obtained a family history, performed electrocardiograms, and drew blood for DNA extraction and genotyping from 15 family members representing 4 generations of an affected family. Seven individuals demonstrated prolonged QT intervals. The authors used polymorphic short tandem repeat markers at known LQTS loci, which indicated linkage to chromosome 11p15.5 where the potassium channel, KCNQ1, is encoded. Polymerase chain reaction was used to amplify the coding region of KCNQ1. During survey of the KCNQ1 coding region, a G-to-A transition (G502A) was identified. DNA from all clinically affected but from none of the clinically unaffected family members carried the G-to-A transition. The candidate locus approach allowed an efficient mechanism to uncover the potassium channel mutation causing LQTS in this family.

scholarly journals Mexiletine Prevents Recurrent Torsades de Pointes in Acquired Long QT Syndrome Refractory to Conventional Measures

2015 ◽  
Vol 1 (4) ◽  
pp. 315-322 ◽  
Author(s):  
Marwan Badri ◽  
Aashay Patel ◽  
Chinmay Patel ◽  
Guizhi Liu ◽  
Matthew Goldstein ◽  
...  
Keyword(s):  
Long Qt Syndrome ◽  
Torsades De Pointes ◽  
Long Qt ◽  
Acquired Long Qt Syndrome ◽  
Qt Syndrome

CESIUM INDUCED ACQUIRED LONG QT SYNDROME LEADING TO TORSADES DE POINTES

2018 ◽  
Vol 71 (11) ◽  
pp. A2612 ◽  
Author(s):  
Hetavi Mahida ◽  
Obiora Maludum ◽  
Nene Ugoeke ◽  
Bharatsinh Gharia ◽  
Dawn Calderon ◽  
...  
Keyword(s):  
Long Qt Syndrome ◽  
Torsades De Pointes ◽  
Long Qt ◽  
Acquired Long Qt Syndrome ◽  
Qt Syndrome

Acquired long QT syndrome from stress cardiomyopathy is associated with ventricular arrhythmias and torsades de pointes

Heart Rhythm ◽  
2011 ◽  
Vol 8 (4) ◽  
pp. 555-561 ◽  
Author(s):  
Christopher Madias ◽  
Timothy P. Fitzgibbons ◽  
Alawi A. Alsheikh-Ali ◽  
Joseph L. Bouchard ◽  
Benjamin Kalsmith ◽  
...  
Keyword(s):  
Long Qt Syndrome ◽  
Ventricular Arrhythmias ◽  
Torsades De Pointes ◽  
Stress Cardiomyopathy ◽  
Long Qt ◽  
Acquired Long Qt Syndrome ◽  
Qt Syndrome

scholarly journals Acquired Long QT Syndrome after Acute Myocardial Infarction: A Rare but Potentially Fatal Entity

2020 ◽  
Vol 47 (2) ◽  
pp. 163-164
Author(s):  
Samuel S. Gordon ◽  
John Hollowed ◽  
Justin Hayase ◽  
Carlos Macias ◽  
Jessica Wang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Long Qt Syndrome ◽  
Torsades De Pointes ◽  
Dna Testing ◽  
Long Qt ◽  
Negative Results ◽  
Electrolyte Disturbances ◽  
Acquired Long Qt Syndrome ◽  
History Of ◽  
Qt Syndrome

Acquired long QT syndrome is typically caused by medications, electrolyte disturbances, bradycardia, or catastrophic central nervous system events. We report a case of myocardial infarction–related acquired long QT syndrome in a 58-year-old woman that had no clear cause and progressed to torsades de pointes requiring treatment with isoproterenol and magnesium. Despite negative results of DNA testing against a known panel of genetic mutations and polymorphisms associated with long QT syndrome, the patient's family history of fatal cardiac disease suggests a predisposing genetic component. This report serves to remind clinicians of this potentially fatal ventricular arrhythmia after myocardial infarction.

scholarly journals Fragmented QRS is associated with torsades de pointes in patients with acquired long QT syndrome

Heart Rhythm ◽  
2010 ◽  
Vol 7 (12) ◽  
pp. 1808-1814 ◽  
Author(s):  
Kayo Haraoka ◽  
Hiroshi Morita ◽  
Yukihiro Saito ◽  
Norihisa Toh ◽  
Toru Miyoshi ◽  
...  
Keyword(s):  
Long Qt Syndrome ◽  
Torsades De Pointes ◽  
Long Qt ◽  
Fragmented Qrs ◽  
Acquired Long Qt Syndrome ◽  
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.

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