Novel therapeutics for treatment of long-QT syndrome and torsade de pointes

Ijaz A. Khan, Ramesh M. Gowda

Research output: Contribution to journalReview articlepeer-review

58 Scopus citations

Abstract

Long-QT syndrome is a clinically and genetically heterogeneous syndrome characterized by lengthening of the QT interval and increased dispersion of the ventricular repolarization on surface electrocardiogram and a propensity to malignant ventricular arrhythmias, torsade de pointes and ventricular fibrillation, which may lead to sudden cardiac death. Long-QT syndrome mostly affects adolescents and young adults with structurally and functionally normal hearts and is caused by aberrations in potassium and sodium ion channels. Standard therapies for long-QT syndrome include correction of the underlying cause, alleviation of the precipitating factors, magnesium sulfate, isoproterenol, antiadrenergic therapy (beta-adrenergic receptor blockers, left cervicothoracic sympathectomy), cardiac pacing, and implantable cardioverter defibrillator. The potential therapies include sodium channel blockers (mexiletine, flecainide, lidocaine, pentisomide, phenytoin), potassium, potassium channel activators (nicorandil, pinacidil, cromakalim), alpha-adrenergic receptor blockers, calcium channel blockers, atropine, and protein kinase inhibitors. The purpose of this review is to outline the established therapies and update the recent advances and potential future strategies in the treatment of long-QT syndrome and torsade de pointes.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalInternational Journal of Cardiology
Volume95
Issue number1
DOIs
StatePublished - May 2004
Externally publishedYes

Keywords

  • Acquired long-QT syndrome
  • Cardiac ion channels
  • Congenital long-QT syndrome
  • Polymorphic ventricular tachycardia
  • Primary electrical disease of heart
  • Sudden arrhythmia death syndrome
  • Sudden cardiac death
  • Torsade de pointes
  • Ventricular fibrillation

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