Long QT syndrome - causes and risk factors

Erwin Ciechański, Magda Ciechańska, Krystian Ciechański, Jarosław Szponar

Abstract


Sudden cardiac death is a major public health challenge, which can be caused by genetic or acquired structural or electrophysiological abnormalities. These abnormalities include channelopathies such as long QT, short QT and Brugada syndromes. Long QT syndrome is a cardiac repolarization disorder and is associated with an increased risk of torsades de pointes (TdP). Main causes of acquired syndrome are specific medications and/or electrolytes imbalance. On the other hand common congenital causes are Jervell and Lange-Nielsen or Romano- Ward syndromes.
Patients with risk factors, treated with specified QT prolongating drugs always require slow dose titration and electrocardiography monitoring.
Aim of this study is to comprehensively and critically review the pathomechanisms of QT prolongation, risk factors and prevention methods.

Keywords


Long QT syndrome; sudden cardiac death; QT prolongating drugs; channelopathies.

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References


 Kallergis EM, Goudis CA, Simantirakis EN, Kochiadakis GE, Vardas PE. Mechanisms, risk factors, and management of acquired long QT syndrome: a comprehensive review. ScientificWorldJournal. 2012;2012:212178. 

 Zemrak WR, Kenna GA. Association of antipsychotic and antidepressant drugs with Q-T interval prolongation. Am J Health Syst Pharm. 2008;65:1029–1038. 

Huo J, Wei F, Cai C, Lyn-Cook B, Pang L. Sex-related Differences in Drug-induced QT Prolongation and Torsades de Pointes: a New Model System with Human iPSC-CMs. Toxicol Sci. 2018 Sep 22.

Ozyuncu N, Akturk S, Tan Kurklu TS, Erol C. Acute coronary syndrome-like

presentation with prolonged QT interval: an unusual case of pheochromocytoma. BMJ

Case Rep. 2016 Sep 26;2016.

Demirtaş K, Yayla Ç, Yüksel M, Açar B, Ünal S, Ertem AG, Kaplan M, Akpinar MY,

Kiliç ZMY, Kayaçetin E. Tp-e interval and Tp-e/QT ratio in patients with celiac

disease. Rev Clin Esp. 2017 Nov;217(8):439-445.

Drew BJ, Ackerman MJ, Funk M, Gibler WB, Kligfield P, Menon V, et al. Prevention of torsade de pointes in hospital settings: a scientific statement from the American Heart Association and the American College of Cardiology Foundation. Circulation. 2010;121:1047–1060. 

Trinkley KE, Page RL, 2nd, Lien H, Yamanouye K, Tisdale JE. QT interval prolongation and the risk of torsades de pointes: essentials for clinicians. Curr Med Res Opin. 2013;29:1719–1726.

Vandael E, Vandenberk B, Vandenberghe J, Willems R, Foulon V. Risk factors for QTc-prolongation: systematic review of the evidence. Int J Clin Pharm. 2017;39:16–25. 

Klivinyi C, Bornemann-Cimenti H. Pain medication and long QT syndrome. The Korean Journal of Pain. 2018;31(1):3-9.

Niemeijer MN, van den Berg ME, Eijgelsheim M, et al. Pharmacogenetics of drug-induced QT interval prolongation: an update. Drug Saf. 2015;38:855-67.

Konstantopoulou A, Tsikrikas S, Asvestas D, et al. Mechanisms of drug-induced proarrhythmia in clinical practice. World J Cardiol. 2013;5:175-85.

Frommeyer G, Eckardt L. Drug-induced proarrhythmia: risk factors and electrophysiological mechanisms. Nat Rev Cardiol. 2016;13:36-47.

Letsas K, Korantzopoulos P, Pappas L, Evangelou D, Efremidis M, Kardaras F. QT interval prolongation associated with venlafaxine administration. Int J Cardiol. 2006;109:116–117.

Letsas KP, Kavvouras C, Kollias G, et al. Drug-induced Brugada syndrome by noncardiac agents. Pacing Clin Electrophysiol. 2013;36:1570-7.

Zapalska-Pozarowska K, Szponar J, Tchórz M, Kostek H, Pozarowski W. [Severe tricyclic antidepressants poisoning--a case study]. Przegl Lek. 2012;69(8):621-3. (in Polish).

Poluzzi E, Raschi E, Godman B, Koci A, Moretti U, Kalaba M, et al. Pro-arrhythmic potential of oral antihistamines (H1): combining adverse event reports with drug utilization data across Europe. PLoS One. 2015 Mar 18;10(3):e0119551.

Woosley R, Heise CW, Romero KA. QTdrugs List. AZCERT, Inc., 1822 Innovation Park Dr., Oro Valley, AZ 85755. www.CredibleMeds.org [accessed 12.01.17].

Westermeyer J, Adabag S, Anand V, Thuras P, Yoon G, Batres-Y-Carr T. Methadone maintenance dose/weight ratio, long QTc, and EKG screening. Am J Addict. 2016;25:499–507. 

Kovac AL. Comparative pharmacology and guide to the use of the serotonin 5-HT3 receptor antagonists for postoperative nausea and vomiting. Drugs. 2016;76:1719–1735. 

Gau JT, Yang YX, Chen R, Kao TC. Uses of proton pump inhibitors and hypomagnesemia. Pharmacoepidemiol Drug Saf. 2012;21:553–559. 

Akita M, Kuwahara M, Tsubone H, Sugano S. ECG changes during furosemide-induced hypokalemia in the rat. J Electrocardiol. 1998;31:45–49. 

Nakano Y, Shimizu W. Genetics of long-QT syndrome. J Hum Genet. 2016. Jan;61(1):51-5.

Beitland S, Platou ES, Sunde K. Drug-induced long QT syndrome and fatal arrhythmias in the intensive care unit. Acta Anaesthesiol Scand. 2014;58:266-7.




DOI: http://dx.doi.org/10.5281/zenodo.1461597

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