| Autor: |
Svernhage, Elisabeth, Houltz, Birgitta, Blomström, Per, Brachmann, Johannes, Crijns, Harry, Jensen, Steen, Vallin, Hans, Swedberg, Karl, Edvardsson, Nils |
| Zdroj: |
Annals of Noninvasive Electrocardiology; Jul1998, Vol. 3 Issue 3, p252-260, 9p |
| Abstrakt: |
Background: The aim of the present analysis was to identify early changes in the surface ECG predicting development of torsades de pointes (TdP) during treatment with almokalant, a Class III antiarrhythmic compound. Methods and Results: In two studies with identical protocols, five patients were reported to have developed TdP. The proarrhythmia occurred 43-137 minutes after start of infusion of almokalant, a selective IKr-blocking substance. Precordial ECG leads V1-V6 were continuously recorded on tape and analyzed for ECG changes during the first 40 minutes of infusion. The tape recording for one patient was, however, technically insufficient for analysis. Each of the remaining four patients was compared with two control patients from the same study and matched for gender, age, conversion to sinus rhythm, and plasma drug concentration. Prolongation of the QTtop interval, i.e., from the beginning of the Q wave to the first identifiable top of the TU complex, was significantly greater during the 40-minute period (P = 0.009) among the TdP cases compared with controls. Remarkably, the increase was twice that seen in controls within the first 10 minutes of infusion. A significantly greater increase in the interlead QT dispersion (P = 0.0496) and the intralead QT variability were also observed over the 40 minutes. Conclusion: Our analysis indicates that a rapidly developing and pronounced increase in QTtop duration, a significant increase in interlead QT dispersion, as well as an increased intralead QT variability, characterized patients who developed TdP when treated with an IKr channel-blocking substance, as compared to identically treated patients without TdP. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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