Hospital care providers need to be more aware that cardiac arrest from a medication-induced heart rhythm problem is a rare but potentially catastrophic event in patients, according to a joint scientific statement from the American Heart Association and American College of Cardiology.
The statement, published online in Circulation: Journal of the American Heart Association and Journal of the American College of Cardiology, is endorsed by the American Association of Critical-Care Nurses.
The rhythm disturbance, called Torsade de Pointes (TdP), has a characteristic electrocardiogram (ECG) pattern described as a "twisting" of points on the read-out. The abnormal rhythm is associated with a drop in blood pressure, which can lead to fainting. TdP may also lead to a more serious rhythm disturbance called ventricular fibrillation, which may cause sudden cardiac arrest. TdP is a special concern for patients in intensive care units (ICU).
Medicines that prolong the heart's Q-T interval increase the risk for TdP. The Q-T interval is a measurement on an ECG that represents the time for electrical activation and inactivation of the ventricles, the lower chambers of the heart.
"This scientific statement is particularly important for healthcare professionals who administer QT-prolonging drugs in hospital units where patients have continuous ECG monitoring such as in ICUs," said Barbara J. Drew, R.N., Ph.D., chair of the statement writing committee. "If the ECG warning signs of TdP are recognized on the patient's cardiac monitor, then TdP and subsequent cardiac arrest should be avoidable."