The prevalence of long QT interval in post-operative intensive care unit patients

Pham, Julius Cuong; Banks, Michael; Narotsky, David L.; Dorman, Todd; Winters, Bradford D.

doi:10.1007/s10877-015-9736-1

Cited by 6 publications

(6 citation statements)

References 38 publications

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“…Electrocardiographic markers for prediction of susceptibility to arrhythmia occurrence such as T peak -T end (Tp-Te), corrected QT interval (QTc) and short-term variability of QT interval (STV QT ) have been previously described [ 28 , 32 , 40 ]. Nevertheless, not all dogs undergoing splenectomy develop fatal arrhythmia.…”

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confidence: 99%

Imbalance of autonomic nervous systems involved in ventricular arrhythmia after splenectomy in dogs

Pastarapatee

Kijtawornrat

Buranakarl

2017

The Journal of Veterinary Medical Science

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The role of cardiac autonomic modulation on ventricular arrhythmia, known as ventricular premature complexes (VPC), after splenectomy was investigated. Twelve dogs undergoing splenectomy were divided into 2 groups: low VPC (<1,000/day, n=6) and high VPC groups (≥1,000/day, n=6). Electrocardiograph recording was performed prior to (D0), during the first three days (D1–3) and on day 9 (D9) after surgery. Arrhythmic indices, Tpeak-Tend, corrected QT interval and short-term variability of QT interval as well as heart rate variability (HRV) were evaluated. Plasma concentrations of norepinephrine (NE) and epinephrine (E) were measured. In the high VPC group, the occurrences of VPC were significantly increased (P<0.05) after surgery, and reached the levels higher than those in the low VPC group. For the arrhythmic indices, only Tp-Te in the high VPC group increased significantly (P<0.05) after surgery. For HRV analysis, enhancement of both time and frequency domains were found postoperatively in both groups. On D2, however, the high VPC group showed significantly lower total power and high frequency with higher low to high frequency ratio (P<0.05) than the low VPC group. Plasma NE concentration significantly increased in the high VPC group after surgery. Dogs in the high VPC group had shorter survival time than those in the low VPC group. In conclusion, dogs with imbalance cardiac autonomic modulation accompanied with high circulating NE concentration after splenectomy are prone to ventricular arrhythmia, which leads to short survival time.

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confidence: 99%

Imbalance of autonomic nervous systems involved in ventricular arrhythmia after splenectomy in dogs

Pastarapatee

Kijtawornrat

Buranakarl

2017

The Journal of Veterinary Medical Science

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“…Tisdale et al, in a prospective one year study in 2 intensive care units, detected a prevalence of 27.9% (251/900) of QTc> 470 ms in men and QTc> 480 ms in women, where 18.2% (164/900) had QTc> 500 ms (10). Another study observed only critical post-surgical patients for 15 months and identified a prevalence of 67% (172/257) of QTc prolongation > 440 ms [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

QTc interval prolongation in critically ill patients: Prevalence, risk factors and associated medications

et al. 2018

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PurposeTo investigate the prevalence and risk factors of acquired long QT syndrome (LQTS) on admission to a general Intensive Care Unit (ICU), and to assess the risk of LQTS associated with prescribed medications.MethodsProspective observational, cross-sectional study approved by the Institutional Review Board. Between May 2014 and July 2016, 412 patients >18 years-old consecutively admitted to the ICU of a university hospital were included. LQTS was defined as a QT interval on the admission electrocardiogram corrected using Bazett’s formula (QTc) >460 ms for men and >470 ms for women. All medications administered within 24 hours before admission were recorded. Logistic regression was used.ResultsLQTS prevalence was 27.9%. In LQTS patients, 70.4% had ≥ 1 LQTS-inducing drug prescribed in the 24 hours prior to ICU admission versus 70.4% in non-LQTS patients (p = 0.99). Bradycardia and Charlson morbidity index score are independent risk factors for LQTS. Haloperidol (OR 4.416), amiodarone (OR 2.509) and furosemide (OR 1.895) were associated with LQTS, as well as another drug not yet described, namely clopidogrel (OR 2.241).ConclusionsThe LQTS is highly prevalent in critically ill patients, ICU patients are often admitted with LQTS-inducing medications, and patients with slow heart rate or with high Charlson comorbidity index should be evaluated for LQTS.

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“…In other studies, it was estimated that approximately half of all ICU patients may develop QT prolongation [ 7 , 8 ]. QT prolongation is particularly common postoperatively (67% to 80%) [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Development of a Risk Score for QT Prolongation in the Intensive Care Unit Using Time-Series Electrocardiogram Data and Electronic Medical Records

et al. 2021

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Objectives: Drug-induced QT prolongation can lead to life-threatening arrhythmia. In the intensive care unit (ICU), various drugs are administered concurrently, which can increase the risk of QT prolongation. However, no well-validated method to evaluate the risk of QT prolongation in real-world clinical practice has been established. We developed a risk scoring model to continuously evaluate the quantitative risk of QT prolongation in real-world clinical practice in the ICU.Methods: Continuous electrocardiogram (ECG) signals measured by patient monitoring devices and Electronic Medical Records data were collected for ICU patients. QT and RR intervals were measured from raw ECG data, and a corrected QT interval (QTc) was calculated by Bazett’s formula. A case-crossover study design was adopted. A case was defined as an occurrence of QT prolongation ≥12 hours after any previous QT prolongation. The patients served as their own controls. Conditional logistic regression was conducted to analyze prescription, surgical history, and laboratory test data. Based on the regression analysis, a QTc prolongation risk scoring model was established.Results: In total, 811 ICU patients who experienced QT prolongation were included in this study. Prescription information for 13 drugs was included in the risk scoring model. In the validation dataset, the high-risk group showed a higher rate of QT prolongation than the low-and low moderate-risk groups.Conclusions: Our proposed model may facilitate risk stratification for QT prolongation during ICU care as well as the selection of appropriate drugs to prevent QT prolongation.

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The prevalence of long QT interval in post-operative intensive care unit patients

Cited by 6 publications

References 38 publications

Imbalance of autonomic nervous systems involved in ventricular arrhythmia after splenectomy in dogs

Imbalance of autonomic nervous systems involved in ventricular arrhythmia after splenectomy in dogs

QTc interval prolongation in critically ill patients: Prevalence, risk factors and associated medications

Development of a Risk Score for QT Prolongation in the Intensive Care Unit Using Time-Series Electrocardiogram Data and Electronic Medical Records

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