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Proarrhythmia (Secondary)

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Cardiac Arrhythmias

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Abstract

Proarrhythmia is defined as the generation of new or worsened arrhythmias with drug therapy. Specific proarrhythmia syndromes, each with distinct mechanism and approach to therapy, have been described. The recognized examples are digitalis intoxication, proarrhythmia associated with sodium-channel block, and torsade de pointes (TdP) occurring during QT-prolonging therapies. In addition, because proarrhythmia often seems to develop in the absence of clear risk predictors, a role for genetics in predisposing to this reaction has been postulated. Acquired long QT syndromes (LQTSs) describe pathologic excessive prolongation of the QT interval, with risk for TdP upon exposure to drug therapy. The wide array of drugs with potential for QT prolongation, the large number of patients exposed to such drugs, the difficulty in predicting the risk, and the potentially fatal outcome make acquired LQTS an important public health problem. The best approach to therapy is to identify the patients at risk, to recognize proarrhythmia, to withdraw the offending agents, and to use specific therapies when available.

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Author information

Authors and Affiliations

  1. Department of Cardiology, S.L. Raheja (a Fortis Associate) Hospital, Mumbai, MH, India

    Debabrata Dash MD, DM, FICC, FCCP, FSCAI, FAPSC

Authors
  1. Debabrata Dash MD, DM, FICC, FCCP, FSCAI, FAPSC
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Corresponding author

Correspondence to Debabrata Dash MD, DM, FICC, FCCP, FSCAI, FAPSC .

Editor information

Editors and Affiliations

  1. Department of Cardiology, Center Hospitalier Coutances, Coutances, France

    Ambrose S. Kibos

  2. Department of Internal Medicine Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

    Bradley P. Knight

  3. Division of Cardiology, McGill University Health Center, Montreal, Québec, Canada

    Vidal Essebag

  4. Department of Cardiology, Miami Children's Hospital, Miami, Florida, USA

    Steven B. Fishberger

  5. School of Biology, Chemistry and Health, Manchester Metropolitan University, Manchester, United Kingdom

    Mark Slevin

  6. “Acad. Vasile Candea” Emergency Clinical Center for Cardiovascular Diseases, “Carol Davila” University of Medicine and Pharmacy, “Titu Maiorescu” University Faculty of Medicine,, Bucharest, Romania

    Ion C. Țintoiu

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© 2014 Springer-Verlag London

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Dash, D. (2014). Proarrhythmia (Secondary). In: Kibos, A., Knight, B., Essebag, V., Fishberger, S., Slevin, M., Țintoiu, I. (eds) Cardiac Arrhythmias. Springer, London. https://doi.org/10.1007/978-1-4471-5316-0_26

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  • DOI: https://doi.org/10.1007/978-1-4471-5316-0_26

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-5315-3

  • Online ISBN: 978-1-4471-5316-0

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