Why the study?
Is clozapine-associated tachycardia persistent over 24 hours in treated patients?
Is clozapine-associated tachycardia persistent over 24 hours in treated patients?
Clozapine-associated tachycardia is persistent throughout a 24-hour period, highlighting the need for guidelines on its detection and management.
Clozapine tachycardia persists on 24-hour monitoring; leaves open whether ambulatory assessment or rate control alters outcomes.
Tachycardia is associated with cardiovascular mortality. Tachycardia is also a known clozapine adverse effect. However, whether clozapine-associated tachycardia is persistent is not known. Thirty clozapine-treated patients with clinical tachycardia were investigated with 24-hour ambulatory electrocardiography (ECG). Baseline peripheral heart rate (HR) was 106.7±7.8. The ambulatory ECG 24-hour-HR was 98.7±9.7. Baseline HR and 24-hour-HR correlated strongly (r=0.74, p=0.000003). Daytime HR was 106.4±9.9 and nighttime HR 89.2±12.0. Low dose bisoprolol reduced HR significantly. The high 24-hour-HR indicates a persistent tachycardia. Tachycardia should not discourage from clozapine use but the findings indicate a need of guidelines for detection and treatment of clozapine-associated tachycardia.
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Nilsson et al. (2018) studied this question.
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