Electrocardiographic findings after 5‐HT₃ receptor antagonists and chemotherapy in children with cancer

Abstract

Although we observed minor ECG changes after 5-HT3 receptor antagonists and chemotherapy, neither dangerous rhythm disturbances nor serious ECG changes were seen.

Comparative safety and effectiveness of serotonin receptor antagonists in patients undergoing chemotherapy: a systematic review and network meta-analysis

“…Some evidence suggests that they prolong the QT interval on electrocardiography [17, 18], which is associated with an increased risk of serious ventricular arrhythmias (e.g., torsades de pointes). In vitro studies have indicated that 5-HT 3 receptor antagonists block voltage-dependent sodium channels and human ether-a-go-go-related gene potassium channels (cardiac ion channels), with the magnitude and type of electrocardiographic change depending on the particular drug.…”

Comparative safety of serotonin (5-HT3) receptor antagonists in patients undergoing surgery: a systematic review and network meta-analysis

“…Serotonin (5-HT 3 ) receptor antagonists reduce nausea and vomiting by inhibiting vagal nerves in the central nervous system and intestinal mucosa [3]. However, some evidence suggests that 5-HT 3 receptor antagonists can increase the risk of cardiac harm in children undergoing chemotherapy [4, 5]. Adverse events associated with these medications include a decrease in heart rate and prolongation of the QT interval.…”

Interventions to decrease the risk of adverse cardiac events for post-surgery or chemotherapy patients taking serotonin (5-HT3) receptor antagonists: protocol for a systematic review and network meta-analysis

“…In the second study, a similar transient increase in the QT interval was observed, but was not found to be clinically significant [11]. In this study, the prolonged QT interval was associated with the 5-HT3 receptor antagonist granisetron but not with ondansetron [11]. The relationship between 5-HT3 receptor antagonists and cardiac risk has not been confirmed by systematic review.…”

“…In the first study, the QT interval was increased up to 24 hours after the antiemetic was given, but this was asymptomatic and serious arrhythmias were not noted [10]. In the second study, a similar transient increase in the QT interval was observed, but was not found to be clinically significant [11]. In this study, the prolonged QT interval was associated with the 5-HT3 receptor antagonist granisetron but not with ondansetron [11].…”

“…For example, two studies examining chemotherapy among children found that 5-HT3 induced prolongation of the QT interval [10,11]. In the first study, the QT interval was increased up to 24 hours after the antiemetic was given, but this was asymptomatic and serious arrhythmias were not noted [10].…”