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Classification of LQTS Cases*


*According to Confidence in Drug-Induced Long QT Syndrome Diagnosis and the Presence of Cofactors

Definitions

Drug-induced Long QT syndrome (LQTS):
Prolonged QT intervals (QTc>460 msec) plus polymorphic ventricular arrhythmia fitting the description of torsades de pointes temporally associated with the administration of a drug or combination of drugs.

Drug-induced LQTS Cofactors:
Agents or conditions known to induce or facilitate the induction of LQTS (e.g., agents that directly prolong the QT interval, including drugs that inhibit the metabolism of drugs known to prolong the QT interval), and conditions such as hypokalemia, hypomagnesemia and bradycardia that might enhance the action of an agent that induces LQTS.

Classification of Episodes When Temporally Associated with Drug Administration

   
  High confidence in Drug-induced LQTS diagnosis:
 
  Electrocardiographic documentation of long QT and torsades de pointes
 
  Sudden death, ventricular tachycardia, or torsades de pointes with measurements, statement, or electrocardiograms, indicating prolonged QT intervals.
 
 
 
Medium confidence in Drug-induced LQTS diagnosis:
 
 
 
 
 
 
Low confidence in Drug-induced LQTS diagnosis:
 
 
 
 
Isolated QT prolongation:
 
 
Not Drug-induced LQTS:
 
 
This classification is adapted with permission from the work of Drs. Ralph Lazarra, Doug Zipes and Jean Barbey.
 
 

Arizona Center for Education and Research on Therapeutics
The Critical Path Institute

Tucson, Arizona and Rockville, Maryland

Funded in part by Agency for Healthcare Research and Quality grant 1 U18 HS10385-01

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