Administration of antiarrhythmic drugs and torsade de pointes in complete atrioventricular block.

Q: What does this research mean for the field?

Torsades de Pointes (TdP) associated with class Ia antiarrhythmic drugs or complete atrioventricular block is driven by specific risk factors such as female sex, electrolyte imbalances, and baseline QT prolongation, representing an exaggerated response rather than drug overdose, and is most safely and effectively treated with right ventricular pacing. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Mokuo Matsuhisa

doi:10.5105/jse.9.67

January 1, 1989Japanese Journal of ElectrocardiologyOpen Access

Administration of antiarrhythmic drugs and torsade de pointes in complete atrioventricular block.

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Why the study?

What are the risk factors for Torsades de Pointes in patients receiving Class Ia antiarrhythmic drugs or with complete atrioventricular block, and what is the most effective treatment?

Structured PICO

What are the risk factors for Torsades de Pointes in patients receiving Class Ia antiarrhythmic drugs or with complete atrioventricular block, and what is the most effective treatment?

P

Population

15 patients administered Class Ia antiarrhythmic drugs and 11 patients with complete atrioventricular block who developed Torsades de Pointes (TdP), along with their respective control groups.

I

Intervention

Class Ia antiarrhythmic drugs or presence of complete atrioventricular block

C

Comparator

Respective control groups (patients without TdP)

O

Outcome

Risk factors for the occurrence of Torsades de Pointes (TdP) and efficacy of treatmentssafety

Implication

Highlights etiology-specific risks and RV pacing utility; hypothesis-generating pending prospective validation.

Abstract

Ia群抗不整脈薬投与例15例, 完全房室ブロック11例にTorsades de Pointes (TdP) を認め, それぞれの対照群と対比しTdP発生の因子, 治療法について検討した.抗不整脈薬投与群ではTdPは女性, 低K+血症, 投与前からQT延長のある例に多くみられた.TdP発生直前のQTcは0.63±0.06と著明に延長し, 心拍数は58.5±11.4/分と有意に低下した.投与前後のQTcの差 (△QTc) はTdP例で大であった.薬剤血中濃度は治療域以下の例が多く, QTの延長は薬剤の過剰投与ではなく過剰反応が示唆された.薬剤開始からTdP発生までにはばらつきがあり, 増悪因子の重なりでTdPが生じる可能性が考えられた.完全房室ブロック群ではTdPはQT延長例, 高齢者, 低Ca2+血症のある例に多くみられた.心拍数, QRS幅はTdP発生に無関係であり, 徐脈の程度, 補充収縮の部位の関与はみられなかった.治療は両群とも右室ペーシングが最も安全で有効であった.

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Cite This Study

Mokuo Matsuhisa (1989) studied this question.

synapsesocial.com/papers/6a1be6f11567d2fc4d5f3b35 https://doi.org/10.5105/jse.9.67

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Administration of antiarrhythmic drugs and torsade de pointes in complete atrioventricular block.

Structured PICO

Implication

Abstract

Discussion

Cite This Study

Administration of antiarrhythmic drugs and torsade de pointes in complete atrioventricular block.

Structured PICO

Implication

Abstract

Discussion

Cite This Study

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