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MeSH Review

Torsades de Pointes

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Disease relevance of Torsades de Pointes


High impact information on Torsades de Pointes


Chemical compound and disease context of Torsades de Pointes


Biological context of Torsades de Pointes


Anatomical context of Torsades de Pointes


Gene context of Torsades de Pointes

  • Patients with impaired CYP2D6 enzyme activity due to enzyme inhibition by thioridazine might be more prone to increased risk of sudden death due to torsade de pointes type cardiac dysrhythmia [24].
  • BACKGROUND: The cardiac sodium channel (SCN5A) mutation L1825P has been identified in a patient with drug-induced torsade de pointes precipitated by the IKr blocker cisapride [25].
  • It is concluded that modulation of this important K+ current is not the mechanism by which intravenous magnesium terminates drug-induced LQT and torsades de pointes [26].
  • In most cases, the patients had preexisting risk factors for torsade de pointes and/or were receiving other medications known to inhibit the hepatic CYP3A4 enzyme system and the metabolism of cisapride [27].
  • We propose that an increase in cardiac calcium current and reduced trafficking of hERG channels to the cell surface cause QT prolongation and torsade de pointes in patients treated with As(2)O(3) [28].

Analytical, diagnostic and therapeutic context of Torsades de Pointes


  1. Polymorphic ventricular tachycardia (Torsade de Pointes) associated with the use of probucol. Gohn, D.C., Simmons, T.W. N. Engl. J. Med. (1992) [Pubmed]
  2. Cardiac actions of erythromycin: influence of female sex. Drici, M.D., Knollmann, B.C., Wang, W.X., Woosley, R.L. JAMA (1998) [Pubmed]
  3. Long QT syndrome and torsade de pointes in a patient receiving fluconazole. Wassmann, S., Nickenig, G., Böhm, M. Ann. Intern. Med. (1999) [Pubmed]
  4. Antipsychotic drugs: prolonged QTc interval, torsade de pointes, and sudden death. Glassman, A.H., Bigger, J.T. The American journal of psychiatry. (2001) [Pubmed]
  5. Long-term follow-up of amiodarone therapy in the young: continued efficacy, unimpaired growth, moderate side effects. Guccione, P., Paul, T., Garson, A. J. Am. Coll. Cardiol. (1990) [Pubmed]
  6. Dofetilide in patients with congestive heart failure and left ventricular dysfunction. Danish Investigations of Arrhythmia and Mortality on Dofetilide Study Group. Torp-Pedersen, C., Møller, M., Bloch-Thomsen, P.E., Køber, L., Sandøe, E., Egstrup, K., Agner, E., Carlsen, J., Videbaek, J., Marchant, B., Camm, A.J. N. Engl. J. Med. (1999) [Pubmed]
  7. A molecular basis for cardiac arrhythmia: HERG mutations cause long QT syndrome. Curran, M.E., Splawski, I., Timothy, K.W., Vincent, G.M., Green, E.D., Keating, M.T. Cell (1995) [Pubmed]
  8. Mechanism of the cardiotoxic actions of terfenadine. Woosley, R.L., Chen, Y., Freiman, J.P., Gillis, R.A. JAMA (1993) [Pubmed]
  9. Female gender as a risk factor for torsades de pointes associated with cardiovascular drugs. Makkar, R.R., Fromm, B.S., Steinman, R.T., Meissner, M.D., Lehmann, M.H. JAMA (1993) [Pubmed]
  10. Torsades de pointes occurring in association with terfenadine use. Monahan, B.P., Ferguson, C.L., Killeavy, E.S., Lloyd, B.K., Troy, J., Cantilena, L.R. JAMA (1990) [Pubmed]
  11. Torsades de pointes occurring in association with terfenadine use. Mathews, D.R., McNutt, B., Okerholm, R., Flicker, M., McBride, G. JAMA (1991) [Pubmed]
  12. Thioridazine-induced torsade de pointes. Successful therapy with isoproterenol. Kemper, A.J., Dunlap, R., Pietro, D.A. JAMA (1983) [Pubmed]
  13. Astemizole-induced torsade de pointes. Simons, F.E., Kesselman, M.S., Giddins, N.G., Pelech, A.N., Simons, K.J. Lancet (1988) [Pubmed]
  14. Torsade de pointes with prenylamine: do we still need the drug? Fraser, A.G., Ikram, S. Lancet (1986) [Pubmed]
  15. Quinidine-induced action potential prolongation, early afterdepolarizations, and triggered activity in canine Purkinje fibers. Effects of stimulation rate, potassium, and magnesium. Davidenko, J.M., Cohen, L., Goodrow, R., Antzelevitch, C. Circulation (1989) [Pubmed]
  16. Sex difference in risk of torsade de pointes with d,l-sotalol. Lehmann, M.H., Hardy, S., Archibald, D., quart, B., MacNeil, D.J. Circulation (1996) [Pubmed]
  17. Effects of bepridil and CERM 4205 (ORG 30701) on the relation between cardiac cycle length and QT duration in healthy volunteers. Lecocq, B., Lecocq, V., Prost, P.L., Fleurot, O., Boisson, P., Jaillon, P. Am. J. Cardiol. (1990) [Pubmed]
  18. CYP2D6 and CYP2C19 genotypes of patients with terodiline cardiotoxicity identified through the yellow card system. Ford, G.A., Wood, S.M., Daly, A.K. British journal of clinical pharmacology. (2000) [Pubmed]
  19. Treating allergic rhinitis with second-generation antihistamines. Nightingale, C.H. Pharmacotherapy (1996) [Pubmed]
  20. Asynchronous development of electrical remodeling and cardiac hypertrophy in the complete AV block dog. Schoenmakers, M., Ramakers, C., van Opstal, J.M., Leunissen, J.D., Londoño, C., Vos, M.A. Cardiovasc. Res. (2003) [Pubmed]
  21. Torsades de pointes ventricular tachycardia associated with overdose of astemizole. Rao, K.A., Adlakha, A., Verma-Ansil, B., Meloy, T.D., Stanton, M.S. Mayo Clin. Proc. (1994) [Pubmed]
  22. Lack of triggered automaticity despite repolarization abnormalities due to bepridil and lidoflazine. Campbell, R.M., Woosley, R.L., Iansmith, D.H., Roden, D.M. Pacing and clinical electrophysiology : PACE. (1990) [Pubmed]
  23. Drug interaction between mosapride and erythromycin without electrocardiographic changes. Katoh, T., Saitoh, H., Ohno, N., Tateno, M., Nakamura, T., Dendo, I., Kobayashi, S., Nagasawa, K. Japanese heart journal. (2003) [Pubmed]
  24. QTc interval lengthening is related to CYP2D6 hydroxylation capacity and plasma concentration of thioridazine in patients. LLerena, A., Berecz, R., de la Rubia, A., Dorado, P. J. Psychopharmacol. (Oxford) (2002) [Pubmed]
  25. New mechanism contributing to drug-induced arrhythmia: rescue of a misprocessed LQT3 mutant. Liu, K., Yang, T., Viswanathan, P.C., Roden, D.M. Circulation (2005) [Pubmed]
  26. Modulation of HERG potassium channels by extracellular magnesium and quinidine. Po, S.S., Wang, D.W., Yang, I.C., Johnson, J.P., Nie, L., Bennett, P.B. J. Cardiovasc. Pharmacol. (1999) [Pubmed]
  27. Torsade de pointes induced by cisapride/clarithromycin interaction. Piquette, R.K. The Annals of pharmacotherapy. (1999) [Pubmed]
  28. Mechanisms of arsenic-induced prolongation of cardiac repolarization. Ficker, E., Kuryshev, Y.A., Dennis, A.T., Obejero-Paz, C., Wang, L., Hawryluk, P., Wible, B.A., Brown, A.M. Mol. Pharmacol. (2004) [Pubmed]
  29. Sotalol testing unmasks altered repolarization in patients with suspected acquired long-QT-syndrome--a case-control pilot study using i.v. sotalol. Kääb, S., Hinterseer, M., Näbauer, M., Steinbeck, G. Eur. Heart J. (2003) [Pubmed]
  30. Pharmacokinetic, pharmacodynamic, and safety evaluation of an accelerated dose titration regimen of sotalol in healthy middle-aged subjects. Barbey, J.T., Sale, M.E., Woosley, R.L., Shi, J., Melikian, A.P., Hinderling, P.H. Clin. Pharmacol. Ther. (1999) [Pubmed]
  31. Inhibition of HERG potassium channels by the antimalarial agent halofantrine. Tie, H., Walker, B.D., Singleton, C.B., Valenzuela, S.M., Bursill, J.A., Wyse, K.R., Breit, S.N., Campbell, T.J. Br. J. Pharmacol. (2000) [Pubmed]
  32. Electrophysiologic mechanisms for ventricular arrhythmias in left ventricular dysfunction: electrolytes, catecholamines and drugs. Levy, M.N., Wiseman, M.N. Journal of clinical pharmacology. (1991) [Pubmed]
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