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KMID : 1011920100110020024
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International Journal of Arrhythmia
2010 Volume.11 No. 2 p.24 ~ p.27
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Drugs and supplements related to sudden cardiac death
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Choi Eue-Keun
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Abstract
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A wide range of drugs and supplements can cause QT prolongation which could increase the risk of torsade de pointes (TdP) and sudden cardiac death (SCD). Most of the drugs that prolong the QT interval lengthen the cardiac repolarization period mostly by blocking specific cardiac K+ channel (IKr). Triggered beats from early afterdepolarization in the prolonged QT interval may initiate TdP. Transmural dispersion or variability of repolarization caused by drugs could be associated with increased risk of TdP. Bradycardia, electrolyte imbalance, female gender and genetic polymorphism could also play a role in increasing the risk of druginduced TdP. Some weight-loss supplements and herbal supplements are known to have life-threatening adverse cardiac effects. These supplements contain several ingredients, i.e. Ma huang, Citrus aurantium, licorice and guarana, which could result QT prolongation, ventricular fibrillation and SCD. In brief, it is
important to reduce the risk of SCD by avoiding drugs or supplements which could prolong the QT interval and correct predisposing factors for drug-induced TdP.
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KEYWORD
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sudden cardiac death, long QT syndrome, torsade de pointes
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