In this multicenter study a group of 1,011 patients (233 females and 778 males, aged 23-68 years, mean 53) with ischaemic heart disease was included. Only nitrates, nifedipine and diuretics were administered during the investigation. Presence of other chronic disease excluded the patients from study group. In all patients a standard 12-lead electrocardiogram was obtained, from which the QT interval was measured, and its corrected value according to the Bazett's formula calculated [formula: see text] values greater than 440 ms were regarded to be abnormal. A 24-hour ecg ambulatory monitoring was also performed in each patient, and the detected ventricular ectopic activity was classified using the Lown's criteria. Mean QTc values were compared between each class of ventricular arrhythmia. No significant differences were disclosed. All the means were below 440 ms. Also the percentages of patients with a prolonged QTc were similar for all Lown classes of arrhythmia. The patients were then divided into two larger groups: Those with low grade (class 0-2) and high grade (class 3-5) arrhythmia. The portion of patients with the pathologic QTc was not significantly different (21% vs. 28%, NS). Such incidence of QTc prolongation was described for clinically healthy population. Since a 24-hour ecg fails to disclose the entire spectrum of arrhythmia in each individual, the fraction of patients with documented VT/VF in the past was analyzed separately. This subgroup was characterized by more frequent occurrence of QTc prolongation than other patients (35% vs. 20%, p = 0.043). Thus, no firm relationship was found between QTc prolongation and ventricular arrhythmias, but increased QTc favoured the occurrence of VT/VF.
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Eur J Case Rep Intern Med
December 2024
Internal Medicine, Holy Family Hospital, Rawalpindi, Pakistan.
Background: Andersen-Tawil syndrome (ATS) is a rare autosomal dominant disorder caused by variants in the gene. It is associated with periodic paralysis, dysmorphic features and cardiac arrhythmias. The syndrome exhibits incomplete penetrance, leading to a broad spectrum of clinical manifestations, making diagnosis challenging.
View Article and Find Full Text PDFHCA Healthc J Med
December 2024
Heritage Valley Health System, Beaver Falls, PA.
Background: Second-generation antipsychotic medications (SGAs) are often used by primary care physicians (PCPs) to treat multiple psychiatric diagnoses. SGAs have been connected to a number of adverse effects, including cardiovascular disease. Currently, there are no published evidence-based recommendations addressing SGAs and cardiotoxicity that are directed toward PCPs.
View Article and Find Full Text PDFJ Clin Endocrinol Metab
January 2025
Harvard Medical School, Boston, MA, USA.
Background: Our goal was to determine in healthy individuals and individuals with type 2 diabetes the impact of repeated episodes of hypoglycemia on the corrected QT (QTc) interval and the time course for QTc recovery. Further, since hypoglycemia increases aldosterone and patients with primary aldosteronism have prolonged QTc, we also determined whether mineralocorticoid receptor blockade prevents hypoglycemia-induced QTc alterations.
Methods: Twenty-seven healthy participants completed a double-blinded crossover trial contrasting 3 experimental conditions: 1) euglycemia, 2) hypoglycemia, and 3) hypoglycemia with mineralocorticoid receptor blockade pretreatment.
J Clin Pharmacol
January 2025
Department of Clinical Medicine (Pharmaceutical Medicine), Graduate School of Pharmaceutical Sciences, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo, Japan.
Pharmaceutical companies have several options to evaluate drug-induced QT prolongation, often referred to as QT pathways, during clinical development. Current regulatory practices recommend achieving high clinical exposure (HCE) for conventional thorough QT (TQT) studies. An alternative to the TQT study, commonly known as the Q&A 5.
View Article and Find Full Text PDFMedicina (Kaunas)
December 2024
Department of Emergency Medicine, Faculty of Medicine, Gaziantep University, Gaziantep 27410, Turkey.
: In patients with acute coronary syndrome, electrocardiographic parameters, including ST elevation in lead aVR (aVR-STE), ST depression (aVR-STD), and QTc prolongation, are crucial. This study aims to show the predictive value of a longer QTc in emergency department patients with acute coronary syndrome and ≥1 mm ST elevation or depression in the aVR lead in electrocardiography. : A retrospective analysis was conducted on 1273 patients admitted to the emergency department with a preliminary diagnosis of acute coronary syndrome between 2020 and 2023.
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