Prevalence and Clinical Characteristics of Patients with Torsades de Pointes Complicating Acquired Atrioventricular Block
Background: Female gender, degree of QT prolongation, and genetic susceptibility are known risk factors for developing torsades de pointes (TdP) during high-grade atrioventricular block (HG-AVB). Our objective was to analyze the prevalence and clinical characteristics of patients presenting with TdP...
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| Format: | Article |
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MDPI AG
2023-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/3/1067 |
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| author | Sok-Sithikun Bun Nathan Heme Florian Asarisi Fabien Squara Didier Scarlatti Pamela Moceri Emile Ferrari |
| author_facet | Sok-Sithikun Bun Nathan Heme Florian Asarisi Fabien Squara Didier Scarlatti Pamela Moceri Emile Ferrari |
| author_sort | Sok-Sithikun Bun |
| collection | DOAJ |
| description | Background: Female gender, degree of QT prolongation, and genetic susceptibility are known risk factors for developing torsades de pointes (TdP) during high-grade atrioventricular block (HG-AVB). Our objective was to analyze the prevalence and clinical characteristics of patients presenting with TdP and AVB (TdP [+]) in comparison with non-TdP patients with AVB (TdP [−]). Methods: All the ECGs from patients prospectively admitted for AVB (2 to 1, HG, and complete) at the University Hospital of Nice were analyzed. Automated corrected QT (QTc), manual measurements of QT and JT intervals, and Tpeak-to-end were performed at the time of the most severe bradycardia. Results: From September 2020 to November 2021, 100 patients were admitted for HG-AVB. Among them, 17 patients with TdP were identified (8 men; 81 ± 10 years). No differences could be identified concerning automated QTc, manual QTc (Bazett correction), baseline QRS width, or mean left ventricular ejection fraction between the two groups. Potassium serum level on admission and mean number of QT-prolonging drugs per patient were not significantly different between the two groups, respectively: 4.34 ± 0.5 mmol/L in TdP [+] versus 4.52 ± 0.6 mmol/L (<i>p</i> = 0.33); and 0.6 ± 0.7 in TdP [+] versus 0.3 ± 0.5 (<i>p</i> = 0.15). In contrast, manual QTc<sub>FR</sub> (Fridericia correction), JT (Fridericia correction), Tpeak-to-end, and Tpe/QT ratio were significantly increased in the TdP [+] group, respectively: 486 ± 70 ms versus 456 ± 53 ms (<i>p</i> = 0.04); 433 ± 98 ms versus 381 ± 80 ms (<i>p</i> = 0.02); 153 ± 57 ms versus 110 ± 40 ms (<i>p</i> < 0.001); and 0.27 ± 0.08 versus 0.22 ± 0.06 (<i>p</i> < 0.001). Conclusions: The incidence of TdP complicating acquired AVB was 17%. Longer QTc<sub>FR</sub>, JT, and Tpeak-to-end were significantly increased in the case of TdP but also in the presence of permanent AVB during the hospitalization. |
| first_indexed | 2024-03-11T09:38:19Z |
| format | Article |
| id | doaj.art-c663a131984b4d6f919cc675212b4753 |
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| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T09:38:19Z |
| publishDate | 2023-01-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-c663a131984b4d6f919cc675212b47532023-11-16T17:11:16ZengMDPI AGJournal of Clinical Medicine2077-03832023-01-01123106710.3390/jcm12031067Prevalence and Clinical Characteristics of Patients with Torsades de Pointes Complicating Acquired Atrioventricular BlockSok-Sithikun Bun0Nathan Heme1Florian Asarisi2Fabien Squara3Didier Scarlatti4Pamela Moceri5Emile Ferrari6Faculty of Medicine, Pasteur University Hospital, 06000 Nice, FranceFaculty of Medicine, Pasteur University Hospital, 06000 Nice, FranceFaculty of Medicine, Pasteur University Hospital, 06000 Nice, FranceFaculty of Medicine, Pasteur University Hospital, 06000 Nice, FranceFaculty of Medicine, Pasteur University Hospital, 06000 Nice, FranceFaculty of Medicine, Pasteur University Hospital, 06000 Nice, FranceFaculty of Medicine, Pasteur University Hospital, 06000 Nice, FranceBackground: Female gender, degree of QT prolongation, and genetic susceptibility are known risk factors for developing torsades de pointes (TdP) during high-grade atrioventricular block (HG-AVB). Our objective was to analyze the prevalence and clinical characteristics of patients presenting with TdP and AVB (TdP [+]) in comparison with non-TdP patients with AVB (TdP [−]). Methods: All the ECGs from patients prospectively admitted for AVB (2 to 1, HG, and complete) at the University Hospital of Nice were analyzed. Automated corrected QT (QTc), manual measurements of QT and JT intervals, and Tpeak-to-end were performed at the time of the most severe bradycardia. Results: From September 2020 to November 2021, 100 patients were admitted for HG-AVB. Among them, 17 patients with TdP were identified (8 men; 81 ± 10 years). No differences could be identified concerning automated QTc, manual QTc (Bazett correction), baseline QRS width, or mean left ventricular ejection fraction between the two groups. Potassium serum level on admission and mean number of QT-prolonging drugs per patient were not significantly different between the two groups, respectively: 4.34 ± 0.5 mmol/L in TdP [+] versus 4.52 ± 0.6 mmol/L (<i>p</i> = 0.33); and 0.6 ± 0.7 in TdP [+] versus 0.3 ± 0.5 (<i>p</i> = 0.15). In contrast, manual QTc<sub>FR</sub> (Fridericia correction), JT (Fridericia correction), Tpeak-to-end, and Tpe/QT ratio were significantly increased in the TdP [+] group, respectively: 486 ± 70 ms versus 456 ± 53 ms (<i>p</i> = 0.04); 433 ± 98 ms versus 381 ± 80 ms (<i>p</i> = 0.02); 153 ± 57 ms versus 110 ± 40 ms (<i>p</i> < 0.001); and 0.27 ± 0.08 versus 0.22 ± 0.06 (<i>p</i> < 0.001). Conclusions: The incidence of TdP complicating acquired AVB was 17%. Longer QTc<sub>FR</sub>, JT, and Tpeak-to-end were significantly increased in the case of TdP but also in the presence of permanent AVB during the hospitalization.https://www.mdpi.com/2077-0383/12/3/1067atrioventricular blocktorsades de pointesQT interval |
| spellingShingle | Sok-Sithikun Bun Nathan Heme Florian Asarisi Fabien Squara Didier Scarlatti Pamela Moceri Emile Ferrari Prevalence and Clinical Characteristics of Patients with Torsades de Pointes Complicating Acquired Atrioventricular Block Journal of Clinical Medicine atrioventricular block torsades de pointes QT interval |
| title | Prevalence and Clinical Characteristics of Patients with Torsades de Pointes Complicating Acquired Atrioventricular Block |
| title_full | Prevalence and Clinical Characteristics of Patients with Torsades de Pointes Complicating Acquired Atrioventricular Block |
| title_fullStr | Prevalence and Clinical Characteristics of Patients with Torsades de Pointes Complicating Acquired Atrioventricular Block |
| title_full_unstemmed | Prevalence and Clinical Characteristics of Patients with Torsades de Pointes Complicating Acquired Atrioventricular Block |
| title_short | Prevalence and Clinical Characteristics of Patients with Torsades de Pointes Complicating Acquired Atrioventricular Block |
| title_sort | prevalence and clinical characteristics of patients with torsades de pointes complicating acquired atrioventricular block |
| topic | atrioventricular block torsades de pointes QT interval |
| url | https://www.mdpi.com/2077-0383/12/3/1067 |
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