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Research Article| Volume 243, P511-515, September 15, 2017

Incidence of Torsade de Pointes in a tertiary hospital population

  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Eline Vandael
    Correspondence
    Corresponding author at: Clinical Pharmacology and Pharmacotherapy, KU Leuven, Herestraat 49, Box 521, 3000 Leuven, Belgium.
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    KU Leuven – University of Leuven, Department of Pharmaceutical and Pharmacological Sciences, 3000 Leuven, Belgium
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  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Bert Vandenberk
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    KU Leuven – University of Leuven, Department of Cardiovascular Sciences, 3000 Leuven, Belgium

    University Hospitals Leuven, Cardiology, 3000 Leuven, Belgium
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  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Joris Vandenberghe
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    KU Leuven – University of Leuven, Department of Neurosciences, 3000 Leuven, Belgium

    University Hospitals Leuven, Psychiatry, 3000 Leuven, Belgium
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  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Hilde Pincé
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    KU Leuven – University of Leuven, Leuven Institute for Healthcare Policy, 3000 Leuven, Belgium

    University Hospitals Leuven, Medical Coding Department and Management Information Reporting, 3000 Leuven, Belgium
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  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Rik Willems
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    KU Leuven – University of Leuven, Department of Cardiovascular Sciences, 3000 Leuven, Belgium

    University Hospitals Leuven, Cardiology, 3000 Leuven, Belgium
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  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Veerle Foulon
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    KU Leuven – University of Leuven, Department of Pharmaceutical and Pharmacological Sciences, 3000 Leuven, Belgium
    Search for articles by this author
  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

      Abstract

      Background

      Multiple risk factors play a role in the development of QTc-prolongation and Torsade de Pointes (TdP). Cases of TdP are underreported and data on the incidence of TdP is scarce. The aim of this study was to investigate the incidence of TdP in a Belgian university hospital and describe the characteristics of TdP-cases using a risk score.

      Methods

      All cases from 2011 till 2013 coded with the ICD-9 code 427.1 in the University Hospitals of Leuven were selected. The medical files were reviewed and demographical, medical, medication and electrocardiographic data were collected. We focused on TdP-cases that were probably caused by the acquired long QT-syndrome. The RISQ-PATH score was used to quantify the risk in these cases (≥10 points as high risk for QTc-prolongation/TdP).

      Results

      Over three years, 41 TdP-cases were identified of which 19 cases were secondary to the acquired long QT-syndrome (52.6% females, mean age of 74 ± 12 years). This corresponds with an incidence of 0.16 ‰/year in a hospital population. Most of the patients (N = 17) were treated with at least one QTc-prolonging drug (most frequently amiodarone, sotalol and furosemide) of whom 12 patients with ≥1 QTc-prolonging drug of list 1 of CredibleMeds. Fifteen patients had an electrocardiogram in a 24-hours interval before the TdP with a prolonged QTc-interval (≥450/470 ms). All the patients had a RISQ-PATH score ≥ 10.

      Conclusions

      Although the incidence of 0.16 ‰/year might seem low, this means that approximately 173 possibly lethal TdP-cases can be expected in Belgian hospitals each year. All TdP-cases were associated with a high RISQ-PATH score.

      Keywords

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