Investigation Of Amiodarone And Other Induced-QT Prolongation Drug Combination

Objective: QT interval prolongation can induce torsades de pointes which is life-threatening. Although it happens rarely ,the consequence is always fateful.Therefore the clinicians pay more and more attention to the QT interval prolongation.The drugs interaction is one of the most important factors to induce the QT interval prolonged.Other induced-QT prolongation drugs can increase the risk of Amiodarone causing torsades de pointes (TdP).When the patients treated with Amiodarone have hypertesion disease,infection, digestive funcitional disturbance and so on,the drug combination always happens. It is necessary for us to investigate the actuality of the drug combination. The aim of this study is to investigate the current situation that the hospitalized patients treated with Amiodarone and other induced-QT prolongation drugs at the same time in 2010. To study the condition of the attention to using other induced-QT prolongation drugs and QT interval in the patients treated with Amiodarone.To study the drug combination in the death patents of the Vasculocardiology Deparment this year.Methods: To collect the data of the arrhythmia patients from more than 2000 cases who had stayed in the Vasculocardiology Deparment from Jan.2010 to Oct.2010. The standard of choice is who was diagnosed Ventricular fibrillation,Ventricular flutter,Ventricular Tachycardia,Premature ventricualr contraction,Atrial fibrillation,Atrial tachycardia,Atrial premature or Reentrant movement. The data includes age,gender, diagnosis and prognosis of disease.According to the relevant reports about other durgs induced QT interval prolonged(Table 1),to record the QT/QTc interval before durgs combined,the QT/QTc interval after drugs combined,the number and proportion of the cases with drug combination,the number of the patents using Amiodarone with or without other induced-QT prolongation drugs in the cases of TdP, the number of TdP happening in the death cases associated with the drug combination.To find out whether mention the QT interval prolongation by scanning the case histories.Results : 83 cases were treated with Amiodarone.The combined induced-QT prolongation drugs are Felodipine, Nifedipine, Levofloxacin and domperidone.There were 62 cases using Amiodarone alone.There were 21 cases using Amiodarone with other induced-QT prolongation drug,including 19 cases with one durg and 2 cases with two drugs.The proportion of the drug combination is 25.3%.There was no case using Amiodarone with more than two drugs.Each percent of them is 11%,8%,4%,5%.The percent of one drug combined is 23%.The percent of two drugs combined is 2%. There were 55 cases with concurrent hypertesion disease,including 9 cases with Felodipine and 7 cases with Nifedipine .The percent of patients with concurrent hypertesion disease using Amiodarone combined with Felodipine or Nifedipine is 29%.There were 3 cases with concurrent infection. In the patients with concurrent infection, the percent of patients using Amiodarone combined with Levofloxacin is 14% including 2 cases happened QTc prolonged. 4 cases used Amiodarone combined with domperidone,and of which 3 cases happened QTc prolonged. There was no case treated with Amiodarone in the death case.Only 1 case used Amiodarone in the process of rescue without other induced-QT prolongation drug and torsades de pointes happening.There is no case history record to mention paying attention to the QT interval when the patient was treated with Amiodarone.Conclusion: In the department of cardiology of the second hospital of Hebei medical university , the proportion of Amiodarone and Other Induced-QT Prolongation Drug Combination is 25.3% in the patients with Amiodarone in 2010. When the patients are treated with Amiodarone and other induced-QT prolongation drugs at the same time ,we must pay close attention to the QT interval in case of TdP.The patient treated with Amiodarone ,using Other induced-QT prolongation drugs, such as Felodipine, Nifedipine, Levofloxacin and domperidone,we must observe the variation of QT interval and the correlated arrhythmia.We must insure the patient's security of drug combination.