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Clinical Study of Amiodarone‐Associated Torsade De Pointes in Chinese People
Author(s) -
GENG DENGFENG,
JIN DONGMEI,
WANG JINGFENG,
LUO YINGJIA,
WU WEI
Publication year - 2006
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2006.00424.x
Subject(s) - amiodarone , medicine , hypokalemia , incidence (geometry) , qt interval , observational study , atrial fibrillation , cardiology , heart failure , torsades de pointes , physics , optics
Objects: Amiodarone‐associated torsade de pointes (Tdp) has been reported increasingly in China in recent years. In this study, we made clinical analysis of amiodarone‐associated Tdp in Chinese people.Methods: Two major Chinese medical databases were searched to identify articles published during the last 26 years that presented data on amiodarone‐associated proarrhythmic events. The articles were divided into two categories: case reports and observational studies.Results: Fifty‐two Chinese‐language case reports with 98 patients and 2 patients registered in our hospital, total 100 patients about amiodarone‐associated Tdp, were enrolled in the study. Amiodarone‐associated Tdp occurred more frequently in females (68.0%, 68/100). The major primary disease of females was rheumatic heart disease (40.7%, 24/59), while that of males was coronary heart disease (45.8%, 11/24). In most patients, Tdp occurred repeatedly and terminated in 24–48 hours. Some Tdp worsen to ventricular fibrillation and caused 19 patients' death (mortality rate 21.8%, 19/87). Known predisposing factors to the development of Tdp, such as heart failure, hypokalemia, drugs combination, and bradyarrhythmia, existed in many cases. Tdp also occurred in six patients (4 females, 2 males) without any known predisposing factors except QTc interval prolongation. Fourteen observational studies each reported data from at least 100 patients who were treated with amiodarone for at least 1 month. Of 2,354 patients included in these studies, 455 patients exposed to amiodarone were reported to have proarrhythmic events (an overall incidence of 19.3%), while only 4 patients were reported to have Tdp or ventricular fibrillation (an incidence of 0.17%).Conclusions: In conclusion, approximately one‐fifth of the patients have amiodarone‐induced proarrhythmic events, while the incidence of Tdp or ventricular fibrillation is remarkably low. Amiodarone‐associated Tdp occurred more frequently in Chinese females. Known predisposing factors for occurrence of Tdp prevailed in Chinese patients. QTc interval prolongation may be an independent risk factor of amiodarone‐associated Tdp.