|
There is an increasing awareness that drugs which are used
for non-antiarrhythmic cardiovascular and even non-cardiovascular indications, may have profound effects
on repolarization and may even cause serious ventricular tachyarrhythmias under specific circumstances.
Therefore, the need to avoid harm to the patients was seen as the background for this Policy Conference
of the European Society of Cardiology held in the European Heart House, Sophia Antipolis, France, with
participation from the American College of Cardiology (ACC), the American Heart Association (AHA), the
Working Group on Arrhythmias of the ESC, the Food and Drug Administration (FDA), the European Agency
for Medicinal Products (EMEA), the Swedish Medical Drug Agency, the Bundesinstitut für Arzneimittel und
Medizinalprodukte (BfArM), and representatives from industry. The growing interest in the QT interval is
matched by advances in molecular biology, genetics and pharmacology of ion channels. The reasons for
the regulatory, clinical and research interest are that QT interval prolongation, and possibly increased
QT dispersion are considered as risk factor(s) in cardiovascular (CV) as well as non-cardiovascular ‘natural’
diseases.
Not only CV (e.g. antiarrhythmic agents) but also non-CV agents may aggravate and/or provoke malignant
ventricular arrhythmias (especially torsade de pointes (TdP)) and sudden death. Examples of such drugs
that delay ventricular repolarization, and, thus, lengthen the QT interval include cisapride, terfenadine,
terodiline, erythromycin, sertindole, ketanserin, tricyclic antidepressants, and the quinolone antibiotic
sparfloxacin.
|
