Drug-induced arrhythmias

Published: 2010-11-30

Circulation featured a review 5 October 2010 on drug-induced arrhythmias. The review summarises available data on drug-related long-QT syndrome (LQTS) and proarrhythmia. It discusses drug-induced QTc prolongation, drug–drug interactions, drug-induced arrhythmia related to sodium channel blockers and current strategies to reduce drug-associated arrhythmia.

Genetic forms of the LQTS associated with high arrhythmic risk have been causally related to mutations in ion channels responsible for the cardiac action potential. Acquired forms of QTc prolongation and proarrhythmia are frequently related to drug effects on the same ion channels. As with genetic forms of LQTS, there is a wide spectrum of potential drug effects on the QTc interval ranging from trivial to potentially lethal. Drug-induced QTc prolongation is a complicated phenomenon related not just to the properties or dose of a particular drug but also to drug–drug interactions and a variety of patient factors.

Circulation. 2010;122:1426-35.