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Cardiovascular II, 10:30 AM, Monday, February 13, 2017
553: ATRIAL FIBRILLATION IN PATIENTS TAKING KNOWN QTC INTERVAL-PROLONGING DRUGS
University of Tennessee Health Science Center, Memphis, TN.
Purpose of Study QTc interval prolongation involves delayed repolarization of cardiac myocytes and is a risk factor for supra- and ventricular arrhythmias. Patients with atrial fibrillation may have a significant prolongation in QTc duration compared to controls. Many drugs are known to increase the QTc interval. However, the risk of AF in patients receiving such agents is uncertain. In this study we hypothesized a higher occurrence of QTc interval prolongation with atrial fibrillation in patients taking QTc-prolonging drugs when compared to patients in sinus rhythm.
Methods Used A retrospective chart review of 3322 patients at an urban medical center from January 2014 to June 2016 of QTc interval on standard 12-lead ECG was performed. Of these patients, 226 were documented as taking QTc interval-prolonging drugs at the time of their ECG. These drugs included furosemide, fluoroquinolone antibiotics, selective serotonin reuptake inhibitors (SSRI), macrolide antibiotics, as well as patients with a urine drug screen positive for cocaine. The incidence of atrial fibrillation and sinus rhythm for each cohort was then compared.
Summary of Results In patients found to be in sinus rhythm vs. atrial fibrillation, a statistically significant number were found to be taking furosemide (12±5 vs. 50±2; p value <0.01) and SSRIs (9±4 vs. 56±2; p value <0.05). There was no significant difference found in AF in patients taking fluoroquinolones (4±2 vs. 23±1; p value 0.12), macrolides (1±0.4 vs. 14±0.5; p value 1.0) or using cocaine (1±0.4 vs. 11±0.4; p value 1.0).
Conclusions Patients taking furosemide and SSRIs were each at a greater risk of having atrial fibrillation compared to controls in sinus rhythm. It is therefore important to be mindful of these risks and to …
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