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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Article info
Publication history
Published online: May 18, 2017
Accepted:
May 17,
2017
Received in revised form:
May 11,
2017
Received:
February 10,
2017
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
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- Torsade de Pointes: The tip of the icebergInternational Journal of CardiologyVol. 257
