Mexiletine Prevents Recurrent Torsades de Pointes in Acquired Long QT Syndrome Refractory to Conventional Measures

JACC. Clinical Electrophysiology
Marwan BadriGan-Xin Yan

Abstract

The purpose of this study was to examine the role of mexiletine, a late sodium current (INa-L) blocker, in acute termination of torsades de pointes (TdP) refractory to conventional therapy in acquired long QT syndromes (LQTS). Long QT interval can predispose to TdP and is therefore associated with significant mortality. Currently, there is no available pharmacotherapy to target directly the ionic basis of most LQTS for the acute termination of TdP. Earlier evidence highlighted the role of INa-L in the pathophysiology of long QT and TdP, particularly in patients with congenital LQTS. Twelve patients with TdP caused by acquired LQTS were treated with mexiletine after failure of conventional treatment including discontinuation of QT-prolonging drugs, intravenous administration of magnesium, and correction of serum electrolyte abnormalities. No recurrence of TdP occurred within 2 h after initiation of treatment with mexiletine in all 12 patients. Macro T-wave alternans accompanied by QT prolongation, an electrocardiographic precursor of TdP that was seen in 3 patients, was also abolished by mexiletine. Treatment with mexiletine shortened the QTc interval from 599 ± 27 ms to 514 ± 16 ms (p = 0.001). The interval from the peak to the...Continue Reading

References

May 1, 1984·American Heart Journal·R L WoosleyD Roden
Nov 1, 1983·Journal of the American College of Cardiology·G N KayA L Waldo
Sep 1, 1995·Journal of the American College of Cardiology·F Chézalviel-GuilbertJ Weissenburger
Aug 24, 1995·Nature·P B BennettA L George
Apr 1, 1993·Journal of Cardiovascular Electrophysiology·S Banai, D Tzivoni
Mar 1, 1997·Clinical Cardiology·D M Roden
May 30, 1998·Pacing and Clinical Electrophysiology : PACE·D M Roden
Sep 13, 2003·European Journal of Pharmacology·Akira TakaharaKeitaro Hashimoto
Mar 5, 2004·The New England Journal of Medicine·Dan M Roden
Apr 20, 2004·Journal of the American College of Cardiology·Bernard R ChaitmanUNKNOWN MARISA Investigators
Oct 29, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Charles Antzelevitch
May 12, 2006·Journal of Cardiovascular Electrophysiology·Charles Antzelevitch, Luiz Belardinelli
Jan 11, 2007·Journal of Cardiovascular Electrophysiology·Donglin GuoGan-Xin Yan
May 1, 2007·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Serge SicouriCharles Antzelevitch
Feb 5, 2008·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Donglin GuoGan-Xin Yan
Mar 18, 2008·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Heiko MetheStefan Kääb
Jul 30, 2008·Journal of Cardiovascular Electrophysiology·Arthur J MossJennifer L Robinson
Feb 23, 2010·Journal of the American College of Cardiology·Gudrun AntoonsMarc A Vos
Dec 28, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Donglin GuoGan-Xin Yan
Apr 29, 2011·Journal of Electrocardiology·Yoichi YamadaShigeru Saito
Apr 13, 2013·Circulation. Arrhythmia and Electrophysiology·Yuanfeng GaoGan-Xin Yan
Jan 8, 2014·Journal of Cardiovascular Disease Research·Zhigang LiuBoaz D Rosen
Dec 3, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Luiz BelardinelliJohn C Shryock

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Citations

Dec 2, 2017·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Gulhan Tunca Sahin, Yakup Ergul
May 20, 2017·Journal of the American Heart Association·Guizhi LiuGan-Xin Yan
Apr 23, 2019·Circulation. Arrhythmia and Electrophysiology·J Martijn BosMichael J Ackerman
Dec 28, 2019·Renal Failure·Peng LiuGuoliang Li
May 21, 2020·Frontiers in Cardiovascular Medicine·Alexander CarpenterAndrew F James
Feb 23, 2017·Canadian Journal of Physiology and Pharmacology·Zsolt GurabiIstván Koncz
Sep 16, 2020·Circulation·James E TisdaleUNKNOWN American Heart Association Clinical Pharmacology Committee of the Council on Clinical Cardiology and Council on Cardiovascul
Oct 9, 2020·Case Reports in Cardiology·Weng-Chio TamMario Alberto De Brito Lima Evora
Dec 2, 2020·Channels·Kornél KistamásPéter P Nánási
Apr 4, 2021·Journal of Veterinary Cardiology : the Official Journal of the European Society of Veterinary Cardiology·Seunggon Lee, M D Kittleson
May 20, 2021·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Jérôme MontnachGildas Loussouarn
Aug 25, 2021·Journal of Cardiovascular Electrophysiology·Ying YangPing Zhang
Oct 5, 2021·JAMA Internal Medicine·Guoliang LiYang Yan
Nov 19, 2021·European Heart Journal·UNKNOWN Task Force for the management of COVID-19 of the European Society of Cardiology
Dec 6, 2021·Cardiovascular Research·UNKNOWN Task Force for the management of COVID-19 of the European Society of Cardiology

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