Incidence and Risk Factors of QT Prolongation and Torsades de Pointes following Intravenous Amiodarone Administration for Atrial Fibrillation: A Cohort Study.
Introduction: Amiodarone has been reported to be associated with QTc interval prolongation and Torsades de pointes (TdP). This study aimed to assess the incidence and identify the risk factors of QTc prolongation and TdP associated with intravenous amiodarone therapy in patients diagnosed with atria...
| Published in: | Archives of Academic Emergency Medicine Vol. 13; no. 1; pp. 1 - 9 |
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| Main Authors: | , , , , , , , |
| Format: | research Journal Article |
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Shahid Beheshti University of Medical Sciences
2025
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=190500717&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 190500717 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 26454904 MFMK jtl: Archives of Academic Emergency Medicine issn: 26454904 maglogo: N pubinfo: dt: 2025 vid: 13 iid: 1 pid: 87963 pub: Shahid Beheshti University of Medical Sciences artinfo: ui: 190500717 190500717 190500717 10.22037/aaemj.v13i1.2784 190500717 ppf: 1 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Incidence and Risk Factors of QT Prolongation and Torsades de Pointes following Intravenous Amiodarone Administration for Atrial Fibrillation: A Cohort Study. aug: au: Wongsalap, Yuttana Miliam, Waruni Deesham, Suparpish Thepsaen, Arissara Churasae, Aphatsara Poolpun, Duangkamon Thongsri, Tomon Saksit, Niwat affil: Division of Clinical Pharmacy, Department of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand. sug: subj: Long QT Syndrome Epidemiology Long QT Syndrome Risk Factors Torsades de Pointes Epidemiology Torsades de Pointes Risk Factors Risk Assessment Amiodarone Adverse Effects Administration, Intravenous Atrial Fibrillation Drug Therapy Human Funding Source Male Female Retrospective Design Record Review Prospective Studies Electronic Health Records Tertiary Health Care Thailand Incidence Descriptive Statistics Confidence Intervals Amiodarone Administration and Dosage Logistic Regression Multivariate Analysis Odds Ratio Middle Age Aged Comorbidity Heart Failure Hypertension Diabetes Mellitus Data Analysis Software Univariate Statistics Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Introduction: Amiodarone has been reported to be associated with QTc interval prolongation and Torsades de pointes (TdP). This study aimed to assess the incidence and identify the risk factors of QTc prolongation and TdP associated with intravenous amiodarone therapy in patients diagnosed with atrial fibrillation (AF). Methods: A retrospective cohort study was conducted using electronic health records of Buddhachinaraj Hospital, a tertiary care center in Thailand, between January 2016 and September 2019. The study population comprised patients with AF who received intravenous amiodarone therapy. Incidence and associated risk factors for QTc interval prolongation and TdP were assessed using multivariable logistic regression analysis. Results: A total of 2,944 patients were included in the analysis. Among these, 49 cases of intravenous amiodarone-associated QTc interval prolongation or TdP were identified (33 (1.12%) and 16 (0.54%) cases, respectively), corresponding to an overall incidence of 1.66% (95% confidence interval (CI): 1.23 - 2.19). Multivariable analysis revealed that diabetes mellitus (adjusted odds ratio (aOR): 1.85; 95% CI: 1.02 - 3.38; p-value = 0.045), history of stroke (aOR: 3.09; 95% CI: 1.26 - 7.57; p-value = 0.014), use of antipsychotic medications (aOR: 3.07; 95% CI: 1.64 - 5.74; p-value < 0.001), and use of anticholinergic medications (aOR: 3.89; 95% CI: 1.54 - 9.85; p-value = 0.004) were significantly associated with an increased risk of QTc interval prolongation and TdP following amiodarone therapy for AF patients. Conclusion: Although the incidence of QTc interval prolongation and TdP related to intravenous amiodarone therapy in patients with AF was relatively low, the risk was significantly elevated in individuals with diabetes mellitus, a history of stroke, or concurrent use of antipsychotic or anticholinergic agents. These findings underscore the importance of vigilant risk assessment and monitoring in clinical practice to mitigate the potential for intravenous amiodarone-induced arrhythmic complications. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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