Torsades de pointes causes

	Torsades de pointes Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Causes

Long QT syndrome can either be inherited as congenital mutations of ion channels carrying the cardiac impulse/action potential or acquired as a result of drugs that block these cardiac ion currents.

Common causes for torsades de pointes include hypomagnesemia and hypokalemia. It is commonly seen in malnourished individuals and chronic alcoholics. Drug interactions such as erythromycin or Avelox, taken concomitantly with inhibitors like nitroimidazole, Diarrhea, dietary supplements, and various medications like methadone, Lithium, tricyclic antidepressants or phenothiazines may also contribute.

Factors that are associated with an increased tendency toward torsades de pointes include:

Familial long QT syndrome
Class IA antiarrhythmics
Hypomagnesemia
Hypokalemia
Hypoxia
Acidosis
Heart failure
Left ventricular hypertrophy
Slow heart rate
Female gender
Baseline electrocardiographic abnormalities
Renal or liver failure

The List of Drugs that Cause Torsades de pointes

Drugs that are generally accepted to have a risk of causing torsades de pointes:

Drugs that Possibly Cause Torsades de pointes

Drugs that in some reports have been associated with torsades de pointes and/or QT prolongation but at this time lack substantial evidence for causing torsades de pointes.

The List of Drugs that Cause Torsades de pointes in Certain Conditions

Drugs that, in some reports, have been weakly associated with torsades de pointes and/or QT prolongation but that are unlikely to be a risk for torsades de pointes when used in usual recommended dosages and in patients without other risk factors (e.g., concomitant QT prolonging drugs, bradycardia, electrolyte disturbances, congenital long QT syndrome, concomitant drugs that inhibit metabolism)

References