The Comprehensive Systematic Review of Association of QT prolonging medications torsades de pointes in hospitalized patients
Abstract
Introduction: Drug-induced QT interval prolongation and its progression to torsades de pointes (TdP), a potentially fatal polymorphic ventricular tachycardia, represent a significant clinical challenge in hospitalized patients. Numerous medications across various therapeutic classes possess this off-target adverse effect, creating a complex landscape for risk management, especially in vulnerable inpatient populations often burdened by comorbidities, polypharmacy, and acute illness. A comprehensive synthesis of the evidence regarding the incidence, risk factors, and mitigation strategies is crucial for optimizing patient safety. Methods: This systematic review was conducted by screening studies from multiple databases based on pre-defined criteria. The population of interest was hospitalized patients of any age receiving medications known to prolong the QT interval. The primary outcome was the occurrence of TdP, with clear diagnostic criteria required. Included study designs were observational studies, randomized controlled trials, systematic reviews, meta-analyses, or case series with ≥10 patients. Data extraction covered study population, specific QT-prolonging drugs, TdP outcomes, risk factors, QT monitoring methodologies, and key statistical findings (Tleyjeh et al., 2020; Vandael et al., 2017). Results: Analysis of 80 included studies revealed marked heterogeneity in TdP incidence across drug classes. Class III antiarrhythmics (e.g., dofetilide, ibutilide) demonstrated…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 10 participants or records.
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