A case of long QT syndrome type 2 that developed torsades de pointes two days after the initiation of oral β-blocker therapy

Yoneda, Fumiya; Makiyama, Takeru; Miyahara, Kosuke; Fukuoka, Yoshitomo; Aiba, Takeshi; Kimura, Takeshi

doi:10.1016/j.hrcr.2022.08.003

Cited by 2 publications

(2 citation statements)

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“…Notably, in 30% of cases, the QTc decreased below the proarrhythmic threshold of 500 ms during mexiletine therapy 40 . Further case studies have demonstrated the efficacy of mexiletine in terminating TdP in patients with congenital LQT2 41–43 . Mexiletine also shortens the QT interval and reduces TdP in patients with congenital LQT8 resulting from a “gain of function” in the L‐type calcium current 27 .…”

Section: Established and Emerging Clinical Applicationsmentioning

confidence: 99%

“…40 Further case studies have demonstrated the efficacy of mexiletine in terminating TdP in patients with congenital LQT2. [41][42][43] Mexiletine also shortens the QT interval and reduces TdP in patients with congenital LQT8 resulting from a "gain of function" in the L-type calcium current. 27 Similarly, in the context of acquired LQTS, Badri et al showed that mexiletine effectively reduced bradycardiarelated QT prolongation in patients, macroscopic T-wave alternans (TWA) and ultimately prevented TdP recurrence under a variety of pathological conditions (Figure 3).…”

Section: Treatment For Long Qt Syndromes and Torsades De Pointesmentioning

confidence: 99%

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Mexiletine: Antiarrhythmic mechanisms, emerging clinical applications and mortality

Olleik,

Kamareddine,

Spears

et al. 2023

Pacing Clinical Electrophis

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Mexiletine, a class Ib antiarrhythmic drug, exhibits its major antiarrhythmic effect via inhibition of the fast and late Na+ currents in myocardial tissues that are dependent on the opening of Na+ channels for their excitation. Through a comprehensive examination of mexiletine's therapeutic benefits and potential risks, we aim to provide valuable insights that reinforce its role as a vital therapeutic option for patients with ventricular arrhythmias, long QT syndrome, and other heart rhythm disorders. This review will highlight the current understandings of the antiarrhythmic effects and rationales for recent off‐label use and address the mortality and proarrhythmic effects of mexiletine utilizing published basic and clinical studies over the past five decades.

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Section: Established and Emerging Clinical Applicationsmentioning

confidence: 99%