Risk of proarrhythmia with class III antiarrhythmic agents: sex-based differences and other issues.
Although men have a higher risk of atrial fibrillation compared with women, the absolute number of women with atrial fibrillation is greater. Congestive heart failure increases the risk of developing atrial fibrillation in women more than in men, and the prognosis for women with atrial fibrillation...
| Publicado en: | American Journal of Cardiology Vol. 91; pp. 39D - 40 |
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| Autores principales: | , |
| Formato: | review tables/charts tracings Journal Article |
| Publicado: |
Elsevier B.V.
Mar2003 Supplement
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106870750&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106870750 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00029149 AJD jtl: American Journal of Cardiology issn: 00029149 maglogo: N pubinfo: dt: Mar2003 Supplement vid: 91 pid: 82545 pub: Elsevier B.V. place: Philadelphia, Pennsylvania artinfo: ui: 106870750 106870750 NLM12670641 2003127526 10.1016/s0002-9149(02)03378-7 NLM12670641 106870750 ppf: 39D ppct: 1 formats: tig: atl: Risk of proarrhythmia with class III antiarrhythmic agents: sex-based differences and other issues. aug: au: Wolbrette DL Wolbrette, Deborah L affil: Department of Medicine, The Milton S. Hershey Medical Center, Penn State University College of Medicine, Hershey, Pennsylvania 17033, USA sug: subj: Antiarrhythmia Agents Adverse Effects Antiarrhythmia Agents Therapeutic Use Atrial Fibrillation Drug Therapy Atrial Fibrillation Prognosis Sex Factors Torsades de Pointes Risk Factors Antiarrhythmia Agents Pharmacodynamics Electrocardiography Heart Failure Complications Potassium Blood Torsades de Pointes Chemically Induced Torsades de Pointes Prevention and Control ab: Although men have a higher risk of atrial fibrillation compared with women, the absolute number of women with atrial fibrillation is greater. Congestive heart failure increases the risk of developing atrial fibrillation in women more than in men, and the prognosis for women with atrial fibrillation is worse than for men. The longer baseline corrected QT interval in women is well known. The mechanism is likely the result of increased circulating androgens, causing the QT interval to shorten in men after puberty. Female sex is associated with an increased risk of torsades de pointes in the setting of potassium antagonists. Class III antiarrhythmic drugs are frequently used for the treatment of atrial fibrillation in heart failure patients because of their neutral effect on mortality and their tolerance by patients with low ejection fractions. Although amiodarone and azimilide carry a low potential for producing torsades de pointes compared with sotalol and dofetilide, the prevalence of torsades de pointes in women is at least twice that in men for all these drugs. Careful monitoring of the QT interval and potassium level, as well as control of congestive heart failure, can help reduce the risk of proarrhythmia. Avoidance of polypharmacy with other potassium antagonists and unmonitored drug formulation changes are important in the management of all patients taking class III agents, but they are particularly crucial in women with additional risk factors for torsades de pointes. pubtype: Academic Journal doctype: review tables/charts tracings Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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