Risk factors and predictors of Torsade de pointes ventricular tachycardia in patients with left ventricular systolic dysfunction receiving Dofetilide

Henriette Sloth Pedersen; Hanne Elming; Marie Seibaek; Hans Burchardt; Bente Brendorp; Christian Torp-Pedersen; Lars Køber; DIAMOND Study Group

doi:10.1016/j.amjcard.2007.04.020

Risk factors and predictors of Torsade de pointes ventricular tachycardia in patients with left ventricular systolic dysfunction receiving Dofetilide

Henriette Sloth Pedersen, Hanne Elming, Marie Seibaek, Hans Burchardt, Bente Brendorp, Christian Torp-Pedersen, Lars Køber, DIAMOND Study Group

58 Citations (Scopus)

Abstract

The purpose of this study was to identify risk factors of Torsade de pointes (TdP) ventricular tachycardia in patients medicated with a class III antiarrhythmic drug (dofetilide) and left ventricular systolic dysfunction with heart failure (HF) or recent myocardial infarction (MI). The 2 Danish Investigations of Arrhythmia and Mortality on Dofetilide (DIAMOND) studies enrolled patients with HF (DIAMOND-HF) or MI (DIAMOND-MI) and left ventricular systolic dysfunction. The present analysis includes only patients treated solely with dofetilide. The incidence of TdP was 2.1% (32 of 1,511). Twenty-five of the incidences occurred in the DIAMOND-HF study and 7 cases in the DIAMOND-MI study (p = 0.0015). TdP was more frequent in women than in men (47% vs 28%, p = 0.02). Risk factors for developing TdP were female gender (odds ratio 2.2, 95% confidence interval [CI] 1.0 to 5.0), MI within 8 weeks (odds ratio 0.3, 95% CI 0.1 to 0.7), being in New York Heart Association class III or IV (odds ratio 3.2, 95% CI 1.2 to 8.6), and baseline QTc duration (odds ratio 1.14, 95% CI 1.00 to 1.30) per 10 ms. Women with chronic HF, QTc duration >400 ms. and New York Heart Association class III or IV had a risk of TdP of 10%, whereas no TdP episodes were observed in patients with QTc duration <400 ms. In conclusion, severity of HF, female gender, and QTc duration make it possible to identify patients with a high risk of early TdP when treated with dofetilide. Patients with recent MI less often had TdP compared with patients with chronic HF.

Original language	English
Journal	American Journal of Cardiology
Volume	100
Issue number	5
Pages (from-to)	876-80
Number of pages	4
ISSN	0002-9149
DOIs	https://doi.org/10.1016/j.amjcard.2007.04.020
Publication status	Published - 2007

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10.1016/j.amjcard.2007.04.020

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Pedersen, H. S., Elming, H., Seibaek, M., Burchardt, H., Brendorp, B., Torp-Pedersen, C., Køber, L., & DIAMOND Study Group (2007). Risk factors and predictors of Torsade de pointes ventricular tachycardia in patients with left ventricular systolic dysfunction receiving Dofetilide. American Journal of Cardiology, 100(5), 876-80. https://doi.org/10.1016/j.amjcard.2007.04.020

Risk factors and predictors of Torsade de pointes ventricular tachycardia in patients with left ventricular systolic dysfunction receiving Dofetilide. / Pedersen, Henriette Sloth; Elming, Hanne; Seibaek, Marie et al.
In: American Journal of Cardiology, Vol. 100, No. 5, 2007, p. 876-80.

Research output: Contribution to journal › Journal article › Research › peer-review

Pedersen, HS, Elming, H, Seibaek, M, Burchardt, H, Brendorp, B, Torp-Pedersen, C, Køber, L & DIAMOND Study Group 2007, 'Risk factors and predictors of Torsade de pointes ventricular tachycardia in patients with left ventricular systolic dysfunction receiving Dofetilide', American Journal of Cardiology, vol. 100, no. 5, pp. 876-80. https://doi.org/10.1016/j.amjcard.2007.04.020

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title = "Risk factors and predictors of Torsade de pointes ventricular tachycardia in patients with left ventricular systolic dysfunction receiving Dofetilide",

abstract = "The purpose of this study was to identify risk factors of Torsade de pointes (TdP) ventricular tachycardia in patients medicated with a class III antiarrhythmic drug (dofetilide) and left ventricular systolic dysfunction with heart failure (HF) or recent myocardial infarction (MI). The 2 Danish Investigations of Arrhythmia and Mortality on Dofetilide (DIAMOND) studies enrolled patients with HF (DIAMOND-HF) or MI (DIAMOND-MI) and left ventricular systolic dysfunction. The present analysis includes only patients treated solely with dofetilide. The incidence of TdP was 2.1% (32 of 1,511). Twenty-five of the incidences occurred in the DIAMOND-HF study and 7 cases in the DIAMOND-MI study (p = 0.0015). TdP was more frequent in women than in men (47% vs 28%, p = 0.02). Risk factors for developing TdP were female gender (odds ratio 2.2, 95% confidence interval [CI] 1.0 to 5.0), MI within 8 weeks (odds ratio 0.3, 95% CI 0.1 to 0.7), being in New York Heart Association class III or IV (odds ratio 3.2, 95% CI 1.2 to 8.6), and baseline QTc duration (odds ratio 1.14, 95% CI 1.00 to 1.30) per 10 ms. Women with chronic HF, QTc duration >400 ms. and New York Heart Association class III or IV had a risk of TdP of 10%, whereas no TdP episodes were observed in patients with QTc duration <400 ms. In conclusion, severity of HF, female gender, and QTc duration make it possible to identify patients with a high risk of early TdP when treated with dofetilide. Patients with recent MI less often had TdP compared with patients with chronic HF.",

author = "Pedersen, {Henriette Sloth} and Hanne Elming and Marie Seibaek and Hans Burchardt and Bente Brendorp and Christian Torp-Pedersen and Lars K{\o}ber and {DIAMOND Study Group}",

note = "Keywords: Aged; Aged, 80 and over; Anti-Arrhythmia Agents; Atrial Fibrillation; Cardiac Output, Low; Cause of Death; Double-Blind Method; Electrocardiography; Female; Forecasting; Heart Arrest; Humans; Male; Middle Aged; Myocardial Infarction; Phenethylamines; Placebos; Potassium Channel Blockers; Risk Factors; Sex Factors; Sulfonamides; Time Factors; Torsades de Pointes; Ventricular Dysfunction, Left",

year = "2007",

doi = "10.1016/j.amjcard.2007.04.020",

language = "English",

volume = "100",

pages = "876--80",

journal = "American Journal of Cardiology",

issn = "0002-9149",

publisher = "Elsevier",

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T1 - Risk factors and predictors of Torsade de pointes ventricular tachycardia in patients with left ventricular systolic dysfunction receiving Dofetilide

AU - Pedersen, Henriette Sloth

AU - Elming, Hanne

AU - Seibaek, Marie

AU - Burchardt, Hans

AU - Brendorp, Bente

AU - Torp-Pedersen, Christian

AU - Køber, Lars

AU - DIAMOND Study Group

N1 - Keywords: Aged; Aged, 80 and over; Anti-Arrhythmia Agents; Atrial Fibrillation; Cardiac Output, Low; Cause of Death; Double-Blind Method; Electrocardiography; Female; Forecasting; Heart Arrest; Humans; Male; Middle Aged; Myocardial Infarction; Phenethylamines; Placebos; Potassium Channel Blockers; Risk Factors; Sex Factors; Sulfonamides; Time Factors; Torsades de Pointes; Ventricular Dysfunction, Left

PY - 2007

Y1 - 2007

N2 - The purpose of this study was to identify risk factors of Torsade de pointes (TdP) ventricular tachycardia in patients medicated with a class III antiarrhythmic drug (dofetilide) and left ventricular systolic dysfunction with heart failure (HF) or recent myocardial infarction (MI). The 2 Danish Investigations of Arrhythmia and Mortality on Dofetilide (DIAMOND) studies enrolled patients with HF (DIAMOND-HF) or MI (DIAMOND-MI) and left ventricular systolic dysfunction. The present analysis includes only patients treated solely with dofetilide. The incidence of TdP was 2.1% (32 of 1,511). Twenty-five of the incidences occurred in the DIAMOND-HF study and 7 cases in the DIAMOND-MI study (p = 0.0015). TdP was more frequent in women than in men (47% vs 28%, p = 0.02). Risk factors for developing TdP were female gender (odds ratio 2.2, 95% confidence interval [CI] 1.0 to 5.0), MI within 8 weeks (odds ratio 0.3, 95% CI 0.1 to 0.7), being in New York Heart Association class III or IV (odds ratio 3.2, 95% CI 1.2 to 8.6), and baseline QTc duration (odds ratio 1.14, 95% CI 1.00 to 1.30) per 10 ms. Women with chronic HF, QTc duration >400 ms. and New York Heart Association class III or IV had a risk of TdP of 10%, whereas no TdP episodes were observed in patients with QTc duration <400 ms. In conclusion, severity of HF, female gender, and QTc duration make it possible to identify patients with a high risk of early TdP when treated with dofetilide. Patients with recent MI less often had TdP compared with patients with chronic HF.

AB - The purpose of this study was to identify risk factors of Torsade de pointes (TdP) ventricular tachycardia in patients medicated with a class III antiarrhythmic drug (dofetilide) and left ventricular systolic dysfunction with heart failure (HF) or recent myocardial infarction (MI). The 2 Danish Investigations of Arrhythmia and Mortality on Dofetilide (DIAMOND) studies enrolled patients with HF (DIAMOND-HF) or MI (DIAMOND-MI) and left ventricular systolic dysfunction. The present analysis includes only patients treated solely with dofetilide. The incidence of TdP was 2.1% (32 of 1,511). Twenty-five of the incidences occurred in the DIAMOND-HF study and 7 cases in the DIAMOND-MI study (p = 0.0015). TdP was more frequent in women than in men (47% vs 28%, p = 0.02). Risk factors for developing TdP were female gender (odds ratio 2.2, 95% confidence interval [CI] 1.0 to 5.0), MI within 8 weeks (odds ratio 0.3, 95% CI 0.1 to 0.7), being in New York Heart Association class III or IV (odds ratio 3.2, 95% CI 1.2 to 8.6), and baseline QTc duration (odds ratio 1.14, 95% CI 1.00 to 1.30) per 10 ms. Women with chronic HF, QTc duration >400 ms. and New York Heart Association class III or IV had a risk of TdP of 10%, whereas no TdP episodes were observed in patients with QTc duration <400 ms. In conclusion, severity of HF, female gender, and QTc duration make it possible to identify patients with a high risk of early TdP when treated with dofetilide. Patients with recent MI less often had TdP compared with patients with chronic HF.

U2 - 10.1016/j.amjcard.2007.04.020

DO - 10.1016/j.amjcard.2007.04.020

M3 - Journal article

C2 - 17719337

SN - 0002-9149

VL - 100

SP - 876

EP - 880

JO - American Journal of Cardiology

JF - American Journal of Cardiology

IS - 5

ER -

Risk factors and predictors of Torsade de pointes ventricular tachycardia in patients with left ventricular systolic dysfunction receiving Dofetilide

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