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Related Concept Videos

Electrocardiogram01:29

Electrocardiogram

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An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
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Acute Coronary Syndrome III: Diagnostic Studies01:30

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
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Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
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Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
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Related Experiment Video

Updated: Mar 6, 2026

Determining the Likelihood of Variant Pathogenicity Using Amino Acid-level Signal-to-Noise Analysis of Genetic Variation
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Development of a risk score for QTc-prolongation: the RISQ-PATH study.

Eline Vandael1, Bert Vandenberk2,3, Joris Vandenberghe4,5

  • 1Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven, Herestraat 49, Box 521, 3000, Leuven, Belgium. Eline.Vandael@kuleuven.be.

International Journal of Clinical Pharmacy
|March 11, 2017
PubMed
Summary

A new RISQ-PATH score effectively identifies patients at low risk for QTc-prolongation when starting new medications. This tool helps clinicians exclude patients from further monitoring with 98.0% negative predictive value.

Keywords:
Observational studyQTc-prolongationRisk managementRisk score

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Area of Science:

  • Cardiology
  • Clinical Pharmacology
  • Drug Safety

Background:

  • Over 170 drugs can cause QTc-prolongation, potentially leading to Torsade de Pointes.
  • Monitoring for drug-induced QTc-prolongation is a significant clinical challenge.
  • Identifying patients at risk is crucial for preventing adverse cardiac events.

Purpose of the Study:

  • To assess the risk of QTc-prolongation in hospitalized patients initiating QTc-prolonging medications.
  • To develop and validate a risk score (RISQ-PATH) for stratifying patients by QTc-prolongation risk.
  • To identify patients who can be safely excluded from intensive QTc monitoring.

Main Methods:

  • Observational study including patients starting haloperidol or QTc-prolonging antibiotics/antimycotics.
  • Electrocardiograms (ECGs) recorded at baseline and follow-up.
  • Collected demographic, medical, and drug data to develop and test the RISQ-PATH score.
  • Receiver Operating Characteristic (ROC) analysis to define the low-risk threshold (<10 points).

Main Results:

  • 178 patients included; mean age 69 years.
  • No significant overall change in QTc-interval from baseline to follow-up.
  • 14.6% of patients developed QTc-prolongation (prolonged QTc-interval ≥450ms [male]/470ms [female]).
  • 25 of 26 patients with QTc-prolongation had a RISQ-PATH score ≥10.
  • The RISQ-PATH score demonstrated 96.2% sensitivity and 98.0% negative predictive value.

Conclusions:

  • The RISQ-PATH score effectively identifies patients at low risk for QTc-prolongation.
  • A score <10 reliably excludes patients from further QTc monitoring.
  • This score is a promising tool for optimizing patient management and reducing unnecessary follow-up.