SynthesisAnesthesia and analgesia2013
Perioperative torsade de pointes: a systematic review of published case reports.
Synthesis in Anesthesia and analgesia, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Effects of esmolol on QTc interval changes during tracheal intubation: a systematic review.BMJ open · 2019Pooled it
- Retrosternal hematoma causing torsade de pointes after coronary artery bypass graft surgery; a case report.Frontiers in cardiovascular medicine · 2024Article
- Class III Antiarrhythmics and Periprocedural Torsades de Pointes.JACC. Case reports · 2023Article
- Thoracic epidural analgesia prolongs postoperative QT interval on electrocardiogram in major non-cardiac surgery: a randomized comparison and a prospective cohort analysis.Frontiers in pharmacology · 2023Article
- Diagnosing Torsades De Pointes Based on Correlation to QT Interval: A Systematic Review.Cureus · 2022Review
- Successful treatment of bepridil-induced intraoperative torsades de pointes by isoproterenol infusion.JA clinical reports · 2021Article
- Perianesthesia Implications and Considerations for Drug-Induced QT Interval Prolongation.Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · 2020Article
- Predisposition of functional genetic variants of A-kinase anchoring protein 10 toward acquired repolarization disorders in high-risk vascular surgery patients.Therapeutics and clinical risk management · 2018Article
- Interleukin-1β gene variants are associated with QTc interval prolongation following cardiac surgery: a prospective observational study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2016Observational
- Clinical manifestations of tension pneumothorax: protocol for a systematic review and meta-analysis.Systematic reviews · 2014Article
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Authors and funding
3 authors at 1 institution in 2 countries.
Funding
Abstract
backgroundTorsade de pointes is a rare but potentially fatal arrhythmia. More than 40 cases of perioperative torsade de pointes have been reported in the literature; however, the current evidence regarding this complication is very limited. To improve our understanding, we performed a systematic review and meta-analysis of all published case reports of perioperative torsade de pointes.
methodsMEDLINE was systematically searched for cases of perioperative torsade de pointes. We included patients of all age groups and cases that occurred from the immediate preoperative period to the third postoperative day. Patient and case characteristics as well as QT interval data were extracted.
resultsForty-six cases of perioperative torsade de pointes were identified; 29 occurred in women (67%), and 2 episodes were fatal (case fatality rate: 4%). Craniotomies and cardiac surgery accounted for 40% of all cases. Preceding events identified by the authors were hypokalemia (12/46, 26%; 99% confidence interval [CI], 9%-43%) and bradycardia (7/46, 15%; 99% CI, 2%-28%). Drugs were implicated in approximately one third of the events (14/46, 30%; 99% CI, 13%-48%). The mean corrected QT (QTc) at baseline was 457 ± 67 milliseconds (minimum 320 milliseconds; maximum 647 milliseconds; data available in 27/46 patients). At the time of the event, the mean QTc increased to 575 ± 77 milliseconds (minimum 413 milliseconds; maximum 766 milliseconds; data available in 33/46 patients). On average, QTc increased by +118 milliseconds (99% CI, 70-166 milliseconds; P < 0.001) between baseline and after the torsade de pointes event. All patients, except for 2, had a substantial prolongation of their QTc interval at the time of the event.
conclusionsThis systematic review identified several common risk factors for perioperative torsade de pointes. Given the nearly uniform presence of a substantial QTc interval prolongation at the time of a torsade de pointes episode, increased vigilance for perioperative QTc interval prolongation may be warranted.
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