AIM: We aimed to report the clinical features related to torsades de pointes (TdP) in patients with complete AV block (CAVB). METHODS: Patients with CAVB who were admitted to our instituition between January 2007 and January 2010 were retrospectively evaluated in terms of the occurence of TdP. The clinical features were compared in patients with and without TdP using the software of SPSS. RESULTS: Sixty-four patients were determined to have CAVB. Three of them had documented episodes of TdP. All three patients experiencing TdP were females, whereas 48% of the patients with CAVB were females. The mean age of patients with TdP was significantly greater than the mean age of the other patients (85 ±3 vs. 78±7.6, respectively; p<0.05). In our archives, bradycardia exposure time could be determined in only 49 patients without TdP. Among them, just 10 patients had been exposed to bradycardia over 48 hours, whereas all of the 3 patients with TdP had been exposed to bradycardia over 48 hours (p<0.05). Additionally, in two patients with TdP, we demonstrated that QT and QTc prolongation increases as the duration of bradycardia is extended. Furthermore, all patients with TdP had notched T waves in the ECG on the occurrence day of TdP, whereas they did not have any notched T wave in their ECG on the admission day. CONCLUSION: Among the patients with CAVB, elderly females are more susceptible to development of TdP. Delay in institution of physiological heart rate leads to further QT prolongation and thereby to TdP. Besides QT prolongation, the finding of T wave notching on ECG may also have a predictive value for TdP.
AIM: We aimed to report the clinical features related to torsades de pointes (TdP) in patients with complete AV block (CAVB). METHODS:Patients with CAVB who were admitted to our instituition between January 2007 and January 2010 were retrospectively evaluated in terms of the occurence of TdP. The clinical features were compared in patients with and without TdP using the software of SPSS. RESULTS: Sixty-four patients were determined to have CAVB. Three of them had documented episodes of TdP. All three patients experiencing TdP were females, whereas 48% of the patients with CAVB were females. The mean age of patients with TdP was significantly greater than the mean age of the other patients (85 ±3 vs. 78±7.6, respectively; p<0.05). In our archives, bradycardia exposure time could be determined in only 49 patients without TdP. Among them, just 10 patients had been exposed to bradycardia over 48 hours, whereas all of the 3 patients with TdP had been exposed to bradycardia over 48 hours (p<0.05). Additionally, in two patients with TdP, we demonstrated that QT and QTc prolongation increases as the duration of bradycardia is extended. Furthermore, all patients with TdP had notched T waves in the ECG on the occurrence day of TdP, whereas they did not have any notched T wave in their ECG on the admission day. CONCLUSION: Among the patients with CAVB, elderly females are more susceptible to development of TdP. Delay in institution of physiological heart rate leads to further QT prolongation and thereby to TdP. Besides QT prolongation, the finding of T wave notching on ECG may also have a predictive value for TdP.
Authors: R J Hidalgo Urbano; E Díaz Infante; A Recio Mayoral; F López Rincón; J Gutiérrez de la Peña; J M Cruz Fernández Journal: An Med Interna Date: 2003-12
Authors: Pentti M Rautaharju; Borys Surawicz; Leonard S Gettes; James J Bailey; Rory Childers; Barbara J Deal; Anton Gorgels; E William Hancock; Mark Josephson; Paul Kligfield; Jan A Kors; Peter Macfarlane; Jay W Mason; David M Mirvis; Peter Okin; Olle Pahlm; Gerard van Herpen; Galen S Wagner; Hein Wellens Journal: Circulation Date: 2009-02-19 Impact factor: 29.690
Authors: Andrew E Epstein; John P DiMarco; Kenneth A Ellenbogen; N A Mark Estes; Roger A Freedman; Leonard S Gettes; A Marc Gillinov; Gabriel Gregoratos; Stephen C Hammill; David L Hayes; Mark A Hlatky; L Kristin Newby; Richard L Page; Mark H Schoenfeld; Michael J Silka; Lynne Warner Stevenson; Michael O Sweeney; Sidney C Smith; Alice K Jacobs; Cynthia D Adams; Jeffrey L Anderson; Christopher E Buller; Mark A Creager; Steven M Ettinger; David P Faxon; Jonathan L Halperin; Loren F Hiratzka; Sharon A Hunt; Harlan M Krumholz; Frederick G Kushner; Bruce W Lytle; Rick A Nishimura; Joseph P Ornato; Richard L Page; Barbara Riegel; Lynn G Tarkington; Clyde W Yancy Journal: J Am Coll Cardiol Date: 2008-05-27 Impact factor: 24.094
Authors: M A Vos; S H de Groot; S C Verduyn; J van der Zande; H D Leunissen; J P Cleutjens; M van Bilsen; M J Daemen; J J Schreuder; M A Allessie; H J Wellens Journal: Circulation Date: 1998-09-15 Impact factor: 29.690
Authors: Ian Topilski; Ori Rogowski; Rafael Rosso; Dan Justo; Yitschak Copperman; Michael Glikson; Bernard Belhassen; Marek Hochenberg; Sami Viskin Journal: J Am Coll Cardiol Date: 2007-01-04 Impact factor: 24.094