Drug-induced pirouette-type tachycardia


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Abstract

Polymorphic ventricular tachycardia (pirouette-type tachycardia, Torsades de Pointes, TdP), having the potential for the development of sudden cardiac death, poses a real threat to human life. The occurrence of TdP is known to be closely associated with lengthening of the QT interval. The effect of drugs is one of the most common causes of the development of acquired prolongation of the QT interval and TdP. The vast majority of the currently existing groups of pharmacological preparations have representatives that are capable of developing an extension of the QT interval and TdP. The most famous and often used of them are antiarrhythmics (IA, IC and class III), antipsychotics, antidepressants, antibiotics (macrolides and fluoroquinolones), antihistamines, antitumor and antifungal drugs, prokinetics, lipid-lowering drugs and diuretics, excluding potassium-sparing agents. Risk factors for drug-induced TdP include old age, bradycardia, the simultaneous use of >1 drug, which contributes to the development of a prolonged QTc interval or TdP, increased plasma concentrations of QT-extending drugs due to drug interactions or inadequate dose adjustment for renal/liver dysfunction, female sex, heart failure with a reduced ejection fraction, history of drug-induced TdP, hypocalcemia, hypokalemia, hypomagnesemia, increased OTc interval by >60 ms compared to the initial value, QTc interval >500 ms, rapid intravenous infusion of drugs that prolong QTc, sepsis, as well as the prolongation of the QTc interval recorded on the electrocardiogram. Assessment of the potential ability of a drug for the development of TdP, identification and correction of the risk factors that increase the likelihood of developing a drug-induced TdP, examination of the initial electrocardiogram and subsequent its monitoring, and awareness of a patient taking a drug with known risk of TdP about the possibility and characteristics of TdP manifestations, are the most important preventive measures that can prevent the arrhythmogenic effects of drugs.

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About the authors

O. D Ostroumova

A.I. Yevdokimov Moscow State University of Medicine and Dentistry; Pirogov Russian National Research Medical University - SABU “Russian Gerontological Scientific and Clinical Center"

Email: ostroumova.olga@mail.ru

I. V Goloborodova

A.I. Yevdokimov Moscow State University of Medicine and Dentistry

References

  1. Trinkley K.E., Page II R.L., Lien H., et al. QT interval prolongation and the risk of torsades de pointes: essentials for clinicians. Curr Med Res Opin. 2013;29:1719-26. doi: 10.1185/03007995.2013.840568.
  2. Schwartz PJ., Woosley R.L. Predicting the unpredictable: drug-induced QT prolongation and torsades de pointes. J Am Coll Cardiol. 2016;67:1639-50. Doi: 10.1016/j. jacc.2015.12.063.
  3. Остроумова О.Д. Удлинение интервала QT РМЖ. 2001;18:750-54. [Ostroumova O.D. QT interval prolongation. RMZh. 2001;18:750-54. (In Russ.)].
  4. Woosley R.L., Heise C.W, Gallo T, et al. CredibleMeds. Avaiable from URL: https:// crediblemeds.org/
  5. Yap Y.G., Camm A.J. Drug induced QT prolongation and torsades de pointes. Heart. 2003;89(11):1363-13. Doi: 10.1136/ heart.89.11.1363.
  6. Darpo B. Spectrum of drugs prolonging QT interval and the incidence of torsades de pointes. Eur Heart J. 2001;3(K):K70-80. doi: 10.1016/S1520-765X.
  7. Astrom-Lilja C., Odeberg J.M., Ekman E., et al. Drug-induced torsades de pointes: a review of the Swedish pharmacovigilance data-base. Pharmacoepidemiol Drug Saf. 2008;17:587-92. doi: 10.1002/pds.1607.
  8. Sarganas G., Garbe E., Klimpel A., et al. Epidemiology of symptomatic drug-induced long QT syndrome and torsade de pointes in Germany. Europace. 2014;6:101-8. Doi:10.1093/ europace/eut214.
  9. Molokhia M., Pathak A., Lapeyre-Mestre M., et al. Case ascertainment and estimated incidence of drug-induced long-QT syndrome: study in Southwest France. Br J Clin Pharmacol. 2008;66:386-95. doi: 10.1111/j.1365-2125.2008.03229.x.
  10. Tisdale J.E., Miller D.A. Drug-induced Diseases: Prevention, Detection, and Management. USA: American Society of Health-System Pharmacists. 2005. 870 p.
  11. Tisdale J.E., Wroblewski H.A., Overholser B.R., et al. Prevalence of QT-interval prolongation in patients admitted to cardiac care units and frequency of subsequent administration of QT-interval prolonging drugs. Drug Saf. 2012;35:459-70. doi: 10.2165/11598160-000000000-00000.
  12. Hoogstraaten E., Rijkenberg S., van der Voort PH.J. Corrected QT-interval prolongation and variability in intensive care patients. J Crit Care. 2014;29:835 39. doi: 10.1016/j.jcrc.2014.05.005
  13. Pickham D., Helfenbein E., Shinn J.A., et al. High prevalence of corrected QT interval prolongation in acutely ill patients is associated with mortality: results of the QT in Practice (QTIP) study. Crit Care Med. 2012;40:394-99. Doi: 10.1097/ CCM.0b013e318232db4a.
  14. Straus S.M., Bleumink G.S., Dieleman J.P, et al. Antipsychotics and the risk of sudden cardiac death. Arch Intern Med. 2004;164:1293-97. Doi: 10.1001 / archinte.164.12.1293
  15. Ray W.A, Chung C.P, Murray K.T., et al. Atypical antipsychotic drugs and the risk of sudden cardiac death. N Engl J Med. 2009;360:225-35. doi: 10.1056/NEJMoa0806994.
  16. Jones M.E., Campbell G., Patel D., et al. Risk of mortality (including sudden cardiac death) and major cardiovascular events in users of olanzapine and other antipsychotics: a study with the General Practice Research Database. Cardiovasc Psychiatry Neurol. 2013;2013:647476. doi: 10.1155/2013/647476.
  17. Weeke P, Jensen A., Folke F, et al. Antipsychotics and associated risk of out-of-hospital cardiac arrest. Clin Pharmacol Ther. 2014;96:490-97. doi: 10.1038/clpt.2011.368.
  18. Wu C.S., Tsai Y.T., Tsai H.J. Antipsychotic drugs and the risk of ventricular arrhythmia and/or sudden cardiac death: a nation-wide case-crossover study. J Am Heart Assoc. 2015;4:e001568. doi: 10.1161/JAHA.114.001568.
  19. Salvo F, Pariente A., Shakir S., et al. Sudden cardiac and sudden unexected death related to antipsychotics: a meta-analysis of observational studies. Clin Pharmacol Ther. 2016;99:306-14. doi: 10.1002/cpt.250.
  20. Cheng J.Y, Nie X.Y., Chen X.M., et al. The role of macrolide antibiotics in increasing cardiovascular risk. J Am Coll Cardiol. 2015;66:2173-84. doi: 10.1016/j.jacc.2015.09.029.
  21. Ray W.A, Murray K.T., Meredith S., et al. Oral erythromycin and the risk of sudden death from cardiac causes. N Engl J Med. 2004;351:1089-96. Doi:10.1056 / NEJMoa 040582.
  22. Rao G.A., Mann J.R., Shoaibi A., et al. Azithromycin and levofloxacin use and increased risk of cardiac arrhythmia and death. Am Fam Med. 2014;12:121-27. doi: 10.1370/afm.1601.
  23. Schembri S., Williamson PA., Short PM., et al. Cardiovascular events after clarithromycin use in lower respiratory tract infections: analysis of two prospective cohort studies. BMJ. 2013;346:f1235. doi: 10.1136/bmj.f1235.
  24. Alkan Y, Haefeli W.E., Burhenne J., et al. Voriconazole-induced QT interval prolongation and ventricular tachycardia: a nonconcentration-dependent adverse effect. Clin Infect Dis. 2004;39:e49-52. Doi: 10.1086/ 423275.
  25. Zeltser D., Justo D., Halkin A., et al. Torsade de pointes due to noncardiac drugs: most patients have easily identifiable risk factors. Medicine. 2003;82:282-90. Doi:0.1097/01. md.0000085057.63483.9b.
  26. Moss A.J., Schwartz PJ., Crampton R.S., et al. The long QT syndrome. Prospective longitudinal study of 328 families. Circulation. 1991;84: 1136-44.
  27. US Department of Health and Human Services (DHHS), Food and Drug Administration, Center for Drug Evaluation and Research *CDER), Center for Biologics Evaluation and Research (CBER). Guidance for industry. E14 clinical evaluation of QT/QTc interval prolongation and proarrhythmic potential for nonantiarrhythmic drugs. Rockville, MD: DHHS. 2005.
  28. Pratt C.M., Al-Khalidi H.R., Brum J.M., et al. Cumulative experience of azimilide-associated torsades de pointes ventricular tachycardia in the 19 clinical studies comprising the azimilide database. J Am Coll Cardiol. 2006;48:471-77.
  29. Tisdale J.E., Jaynes H.A., Kingery J.R., et al. Development and validation of a risk score to predict QT interval prolongation in hospitalized patients. Circ Cardiovasc Qual Outcomes. 2013;6:479 87. doi: 10.1161/CIRCOUTCOMES.113. 000152
  30. Pham T.V, Rosen M.R. Sex, hormones, and repolarization. Cardiovasc Res. 2002;53:740-51. doi: 10.1016/S0008-6363 (01)00429-1.
  31. Hreiche R., Morissette P., Turgeon J. Drug-induced long QT syndrome in women: review of current evidence and remaining gaps. Gend Med. 2008;5:124-35. Doi: 10.1016/j. genm.2008.05.005.
  32. Ebert S.N., LiuX-K, Woosley R.L. Female gender as a risk factor for drug-induced cardiac arrhythmias: evaluation of clinical and experimental evidence. J Wornens Health. 1998;7:547-57. Doi: 10.1089/ jwh.1998.7.547.
  33. Rautaharju PM., Zhou S.H., Wong S., et al. Sex differences in the evolution of the electrocardiographic QT interval with age. Can J Cardiol. 1992;8:690-95.
  34. Makkar R.R., Fromm B.S., Steinman R.T., et al. Female gender as a risk factor for torsades de pointes associated with cardiovascular drugs. JAMA. 1993;270:2590-97. Doi:10.1001/ jama.1993.03510210076031.
  35. Drici M.D., Knollman B.C., Wang W-X., et al. Cardiac actions of erythromycin. Influence of female sex. JAMA. 1998;280:1774-6. Doi: 10.1001 / jama.280.20.1774.
  36. Gowda R.M., Khan I.A., Punukollu G., et al. Female preponderance in ibutilide-induced torsade de pointes. Int J Cardiol. 2004;95:219-22. doi: 10.1016/j.ijcard.2003.04.034.
  37. Roden D., Woosley R., Primm R. Incidence and clinical features of the quinidine-associated long-QT syndrome: implications for patient care. Am Heart J. 1986;111:1088-93. doi: 10.1016/0002-8703(86)90010-4.
  38. Woosley R.L., Chen Y., Freiman J.P, et al. Mechanisms of the cardiotoxic actions of terfenadine. JAMA. 1993;269:1532-36. Doi: 10.1001 / jama.1993.03500120070028.
  39. Curtis L.H., Ostbye T., Sendersky V., et al. Prescription of QT-prolonging drugs in a cohort of about 5 million outpatients. Am J Med. 2003;114:135-41. doi: 10.1016/S0002-9343 (02)01455-9.
  40. Tay K.Y., Ewald M.B., Bourgeois F.T. Use of QT-prolonging medications in US emergency departments, 1995-2009. Pharmacoepidemiol Drug Saf. 2014;23:9-17. Doi: 10.1002/ pds.3455.
  41. Takeuchi H., Suzuki T., Remington G., et al. Antipsychotic polypharmacy and corrected QT interval: a systematic review. Can J Psychiatr. 2015;60:215-22. doi: 10.1177/070674371506000503.
  42. Niemeijer M.N., van den Berg M.E., Franco O.H., et al. Drugs and ventricular repolarization in a general population: the Rotterdam Study. Pharmacoepidemiol Drug Saf. 2015;24:1036-41. doi: 10.1016/j.hrthm.2015.07.011.
  43. Nakano Y, Shimizu W. Genetics of long-QT syndrome. J Hum Genet. 2016;61:51-5. doi: 10.1038/jhg.2015.74.
  44. Yang P, Kanki H., Drolet B., et al. Allelic variants in long-QT disease genes in patients with drug-associated torsades de pointes. Circulation. 2002;105:1943-48. doi: 10.1161/01. CIR.0000014448.19052.4C.
  45. Остроумова О.Д., Голобородова И.В. Лекарственно-индуцированное удлинение интервала QT: распространенность, факторы риска, лечение и профилактика. Consilium medicum. 2019;5:62-67. [Ostroumova O.D., Goloborodova I.V Drug-induced long QT interval: prevalence, risk factors, treatment and prevention. Consilium medicum. 2019;5:62-67. (In Russ.)].
  46. Drew B.J., Ackerman M.J., Punk M., ot al. On behalf of the American Heart Association Acute Cardiac Care Committee of the Council on Clintcal Cardiology, the Council on Cardiovascular Nursing, and the American College of Cardiology Poundation, Prevention of torsade de pointes in hospital settings: a acientific statement from the American Heart Association and the American College of Cardiology Foundation. Circulation. 2010;121:1047-60.
  47. Neumar R.W., Otto C.W., Link M.S., et al. Part 8: adult advanced cardiovascular life support: 2010. American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(3):S729-67. Doi: 10.1161/

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