Torsade de pointes due to quinidine: Observations in 31 patients

Bauman, Jerry L.; Bauernfeind, Robert A.; Hoff, J.; Strasberg, Boris; Swiryn, Steven; Rosen, Kenneth M.

doi:10.1016/0002-8703(84)90081-4

Cited by 201 publications

(70 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The incidence of TdP in patients treated with quinidine whose spectrum of effects includes K channel blockade, has been estimated to range between 2·0% and 8·8% [1][2][3][4] . For d,l-sotalol, an incidence ranging between 1·8% and 4·8% has been described [5][6][7] .…”

Section: The Problemmentioning

confidence: 99%

The potential for QT prolongation and proarrhythmia by non-antiarrhythmic drugs: clinical and regulatory implications. Report on a Policy Conference of the European Society of Cardiology

Haverkamp¹,

Breithardt²,

Janse³

et al. 2000

European Heart Journal

410

273

View full text Add to dashboard Cite

The scientific and clinical basis of drug-induced QT prolongation and proarrhythmia was summarized by formal presentations. The speakers were chosen for their particular competence in the relevant field. Furthermore, selected topics were discussed in detail in separate workshops. This document represents the executive summary of the Conference. It is based on written reports composed by the speakers and the chairs of the workshops. Before preparation of the final version of the document, a draft was circulated to all participants of the Conference for suggestions and comments. The opinions expressed in this document are those of the participants and do not necessarily reflect the official position of their organisations or agencies. The meeting was made possible by unrestricted educational grants to the Committee for Scientific and Clinical Initiatives of the ESC from several companies listed in the Appendix. The problemQT interval prolongation, and possibly increased QT dispersion, are risk factors in a number of cardiovascular as well as non-cardiovascular diseases. A variety of drugs prolong the QT interval, although the major examples are the so-called class III antiarrhythmics. These drugs generally exert their therapeutic effect by affecting potassium ion channels, thereby reducing outward, repolarizing current, and prolonging action potential duration and the QT interval. Many of these drugs have been developed for conversion of atrial fibrillation and/or maintenance of sinus rhythm in patients with recurrent atrial fibrillation. Such patients are at low risk of potentially fatal arrhythmias, at least in the absence of antiarrhythmic drug therapy.However, antiarrhythmic drugs which prolong cardiac repolarization are not harmless, as they may induce

show abstract

Section: The Problemmentioning

confidence: 99%

The potential for QT prolongation and proarrhythmia by non-antiarrhythmic drugs: clinical and regulatory implications. Report on a Policy Conference of the European Society of Cardiology

Haverkamp¹,

Breithardt²,

Janse³

et al. 2000

European Heart Journal

410

273

View full text Add to dashboard Cite

show abstract

“…Quinidine-associated syncope was described nearly 100 years ago (15) and is due to QT interval prolongation and the life-threatening arrhythmia torsades de pointes (TdP) (2), which occurs in up to 8% of quinidinetreated patients (22). TdP is a polymorphic ventricular tachycardia associated with QT interval prolongation and appears on the electrocardiogram (ECG) as continuous "twisting of the pointes" of the QRS complex around the isoelectric baseline (24).…”

mentioning

confidence: 99%

High Risk of QT Interval Prolongation and Torsades de Pointes Associated with Intravenous Quinidine Used for Treatment of Resistant Malaria or Babesiosis

Wroblewski

Kovacs

Kingery

et al. 2012

Antimicrob Agents Chemother

View full text Add to dashboard Cite

dCardiac toxicity may be associated with drugs used for malaria. Torsades de pointes (TdP) is a well-known adverse effect of quinidine when used for atrial fibrillation. Intravenous quinidine doses for resistant malaria are 2 to 3 times higher than those used for arrhythmias. Among 6 patients receiving quinidine for malaria or babesiosis, 4 developed QT interval prolongation and 2 experienced TdP. Clinicians should be aware that recommended doses of quinidine for malaria carry a high TdP risk.

show abstract

“…Drug-induced torsade de pointes is associated with a pause-dependent ('short-long-short') pattern of initiation with QT interval prolongation demonstrated on surface electrocardiogram [24]. The mechanism behind drug-induced torsade is delayed repolarization resulting in early after-depolarization.…”

Section: Antiarrhythmic Drug Therapy and The Risk Of Proarrhythmiamentioning

confidence: 99%

Treatment of Atrial Fibrillation and Flutter: Focus on Oral Dofetilide, a New Selective Class III Antiarrhythmic Agent

2001

View full text Add to dashboard Cite

Atrial fibrillation and atrial flutter, the most common forms of supraventricular tachyarrhythmias, are associated with a high risk of embolic complications, tachycardia-induced ventricular dysfunction, and disabling symptoms. Pharmacological therapy is used to restore or maintain sinus rhythm, prevent recurrences, or control ventricular response rate. The selection of an antiarrhythmic drug for maintenance of sinus rhythm following termination of persistent atrial fibrillation or flutter should balance clinical effectiveness against the potential for adverse events. The risk of drug-induced proarrhythmias is a pertinent safety concern, particularly in patients with underlying structural heart disease. One specific proarrhythmia, polymorphic ventricular tachycardia, commonly known as torsade de pointes, is associated with QT interval prolongation as a result of sodium and potassium channel blockade, observed with the use of class IA and III drugs, respectively. Dofetilide is a new class III antiarrhythmic drug that works by selective potassium channel blockade. As an extension of its pharmacological action, it may exhibit dose-dependent QT prolongation and torsade de pointes. This review focuses on treatment of atrial fibrillation and atrial flutter emphasizing the drug profile of oral dofetilide, its use in clinical studies, and its role in treatment of these arrhythmias.

show abstract

Torsade de pointes due to quinidine: Observations in 31 patients

Cited by 201 publications

References 19 publications

The potential for QT prolongation and proarrhythmia by non-antiarrhythmic drugs: clinical and regulatory implications. Report on a Policy Conference of the European Society of Cardiology

The potential for QT prolongation and proarrhythmia by non-antiarrhythmic drugs: clinical and regulatory implications. Report on a Policy Conference of the European Society of Cardiology

High Risk of QT Interval Prolongation and Torsades de Pointes Associated with Intravenous Quinidine Used for Treatment of Resistant Malaria or Babesiosis

Treatment of Atrial Fibrillation and Flutter: Focus on Oral Dofetilide, a New Selective Class III Antiarrhythmic Agent

Contact Info

Product

Resources

About