Genetic basis of drug-induced arrhythmias

Genetic basis of drug-induced arrhythmias.

Vos MA, Paulussen AD.

Department of Medical Physiology, University Medical Center Utrecht, The Netherlands. [email protected]

Drug-induced torsade de pointes arrhythmia (TdP) is frequently seen in patients. This proarrhythmia is not restricted to anti-arrhythmics but includes a variety of drugs. A genetic predisposition is an attractive explanation for this clinical problem. In this review, we: 1) explain the arrhythmogenic mechanisms of TdP, 2) provide data for a genetic cause based upon mutations in the long QT or in cytochrome genes responsible for drug metabolism, and 3) present pathology-based electrical remodeling as an alternative explanation. It can be concluded that the current evidence for a genetic basis for drug-induced TdP is weak