Drug-Induced Atrial Fibrillation / Atrial Flutter

Drug-induced atrial fibrillation / flutter (DIAF) is a serious and potentially life-threatening complication of pharmacotherapy. Purpose of the work: systematization and analysis of scientific literature data on drugs, the use of which can cause the development of DIAF, as well as on epidemiology, pathophysiological mechanisms, risk factors, clinical picture, diagnosis and differential diagnosis, treatment and prevention of DIAF. Analysis of the literature has shown that many groups of drugs can cause the development of DIAF, with a greater frequency while taking anticancer drugs, drugs for the treatment of the cardiovascular, bronchopulmonary and central nervous systems. The mechanisms and main risk factors for the development of DIAF have not been finally established and are known only for certain drugs, therefore, this section requires further study. The main symptoms of DIAF are due to the severity of tachycardia and their influence on the parameters of central hemodynamics. For diagnosis, it is necessary to conduct an electrocardiogram (ECG) and Holter monitoring of an ECG and echocardiography. Differential diagnosis should be made with AF, which may be caused by other causes, as well as other rhythm and conduction disturbances. Successful treatment of DIAF is based on the principle of rapid recognition and immediate discontinuation of drugs (if possible), the use of which potentially caused the development of adverse drug reactions (ADR). The choice of management strategy: heart rate control or rhythm control, as well as the method of achievement (medication or non-medication), depends on the specific clinical situation. For the prevention of DIAF, it is necessary to instruct patients about possible symptoms and recommend self-monitoring of the pulse. It is important for practitioners to be wary of the risk of DIAF due to the variety of drugs that can potentially cause this ADR.

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Lung Injury Induced by Antitumor Drugs: Diagnosis, Features of the Clinical Course, Risk Factors, Differential Diagnosis, Treatment, and Prevention. Part 1

Tuberculosis and lung diseases ◽

10.21292/2075-1230-2021-99-7-55-62 ◽

2021 ◽

Vol 99 (7) ◽

pp. 55-62

Author(s):

N. V. Orlovа ◽

O. D. Ostroumovа ◽

E. V. Shikh ◽

S. V. Smerdin ◽

E. V. Rebrovа ◽

...

Keyword(s):

Risk Factors ◽

Differential Diagnosis ◽

Early Diagnosis ◽

Lung Injury ◽

Tobacco Smoking ◽

Clinical Course ◽

Antitumor Drugs ◽

Drug Induced ◽

Duration Of Therapy ◽

Treatment And Prevention

57 publications on pneumotoxicity of antitumor drugs were analyzed. It was found that the development of pneumotoxic effects could be influenced by risk factors such as gender, age, tobacco smoking, comorbidities, and duration of therapy. Symptoms of lung injury induced by antitumor drugs are nonspecific thus it is difficult to diagnose them promptly. For prevention, early diagnosis and timely management of drug-induced lung injury during antineoplastic therapy, it is necessary to raise awareness of such a condition in practitioners of different specialties, primarily general practitioners, pulmonologists, phthisiologists, and oncologists.

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Chronic pelvic pain syndrome in women: risk factors, differential diagnosis, treatment and prevention

Problemy reproduktsii ◽

10.17116/repro20212702156 ◽

2021 ◽

Vol 27 (2) ◽

pp. 56

Author(s):

N.I. Tapilskaya ◽

A.V. Mironova ◽

E.A. Silaeva ◽

A.V. Shkarupa ◽

R.I. Glushakov

Keyword(s):

Risk Factors ◽

Differential Diagnosis ◽

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Chronic Pelvic Pain Syndrome ◽

Pain Syndrome ◽

Pelvic Pain Syndrome ◽

Treatment And Prevention

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Atrial fibrillation and supraventricular arrhythmias

The ESC Textbook of Intensive and Acute Cardiovascular Care ◽

10.1093/med/9780198849346.003.0054 ◽

2021 ◽

pp. 719-739

Author(s):

Demosthenes G Katritsis ◽

A John Camm

Keyword(s):

Atrial Fibrillation ◽

Differential Diagnosis ◽

Cycle Length ◽

Accessory Pathway ◽

Atrial Arrhythmias ◽

Supraventricular Arrhythmias ◽

Acute Setting ◽

Epidemiology Data ◽

Life Threatening ◽

Appropriate Therapy

The term supraventricular tachycardia (SVT) refers to atrial arrhythmias, including atrial fibrillation, atrioventricular nodal reentry, and atrioventricular reentry due to accessory pathway(s). In clinical practice, SVT may present as narrow- or wide-QRS tachycardias, and with the potential exception of atrial fibrillation, most of them are usually, although not invariably, manifest as regular rhythms. They are usually intrusive, symptomatic, and anxiety provoking but not dangerous. However, depending on their cycle length and the patient's background, they could also be, rarely, life-threatening conditions. In the acute setting, consideration of epidemiology data, clinical presentation, and the 12 lead ECG can provide diagnostic clues for differential diagnosis between SVT and ventricular arrhythmias, and guide appropriate therapy.

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Drug-induced seizures: prevalence, risk factors, treatment and prevention

Zhurnal nevrologii i psikhiatrii im S S Korsakova ◽

10.17116/jnevro201911911186 ◽

2019 ◽

Vol 119 (11) ◽

pp. 86 ◽

Cited By ~ 1

Author(s):

T. M. Ostroumova ◽

O. D. Ostroumova ◽

E. S. Akimova ◽

A. I. Kochetkov

Keyword(s):

Risk Factors ◽

Drug Induced ◽

Treatment And Prevention ◽

Drug Induced Seizures

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Drug-induced atrioventricular blockages

Medical alphabet ◽

10.33667/2078-5631-2020-19-56-64 ◽

2020 ◽

Vol 1 (19) ◽

pp. 56-64

Author(s):

M. I. Kulikova ◽

O. D. Ostroumova ◽

A. G. Komarova

Keyword(s):

Risk Factors ◽

Heart Rhythm ◽

Inhibitory Effect ◽

Antineoplastic Drugs ◽

Av Node ◽

Drug Induced ◽

Treatment And Prevention ◽

Av Conduction ◽

Common Risk Factors ◽

Conduction Disorder

Atrio-ventricular (AV) blockages are a serious violation of the heart rhythm. One of the reasons for the development of this pathology may be taking medications. This effect has a significant number of drugs used for the treatment of diseases of the cardiovascular system, central nervous system, general and local anesthetics, antineoplastic drugs, and many others. The main mechanism for the development of drug-induced AV blockades is the inhibition of AV node conduction. The most common risk factors for the development of drug-induced AV blockades are taking two and more drugs that have an inhibitory effect on AV conduction, the initial duration of the PQ interval more than 0.2 second, initial dysfunction of the AV node, increased plasma concentration of a potential inducer drug due to the presence of kidney and/or liver disease, drugdrug interactions, and specific risk factors for individual drugs. Special attention in solving this problem should be paid to both stopping the developed AV conduction disorder – medication or using an electric cardiostimulator, and its prevention. This article systematizes the literature data on drug-induced AV blockades in order to increase the awareness of practitioners and patients about their prevalence, risk factors, approaches to diagnosis, treatment and prevention.

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Personalized Medicine in the Treatment of Atrial Fibrillation: Myth or Reality?

Rational Pharmacotherapy in Cardiology ◽

10.20996/1819-6446-2019-15-1-90-94 ◽

2019 ◽

Vol 15 (1) ◽

pp. 90-94

Author(s):

V. I. Podzolkov ◽

A. I. Tarzimanova

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Molecular Genetic ◽

Modern Medicine ◽

Therapeutic Drug ◽

Genetic Studies ◽

Genomic Studies ◽

Familial Atrial Fibrillation ◽

Life Threatening ◽

Genetic Mechanisms

Due to the spectacular progress made in human genomic studies, molecular biology and genetics have become an essential part of modern medicine making it possible to early detect the risk factors and select the personalized treatment. The genetic studies have been widely used in the diagnosis and treatment of arrhythmias. Significant advances in the study of electrophysiological and genetic mechanisms of life-threatening arrhythmias have been achieved through studies of familial conditions with high risk of sudden cardiac death. However, the area of special interest for a practitioner is the identification of mutations associated with atrial fibrillation (AF). The novel methods enable us to study histological, structural, cellular and molecular causes of this arrhythmia. The two main directions of molecular genetic studies of AF are the identification of genetic mutations causing familial atrial fibrillation and the study of different genes polymorphism predisposing to arrhythmia in general population. Gene polymorphism screening helps both identify AF risk factors and predict its evolution from paroxysmal to chronic type. Emerging genetic studies provided explanation for the variable efficacy of antiarrhythmic drugs. It can be assumed that the clinical use of genetic methods will allow accurate and personalized selection of antiarrhythmics. Currently, therapeutic drug monitoring is widely recommended for a number of medications including cytostatics, aminoglycosides, anticonvulsants, and, by some researchers, antiarrhythmic and anticoagulant drugs. Medicine from the very beginning was intended to be personalized, but until recently it was a little more than a myth. The discovery of the human genome makes it possible to choose the most effective treatment with minimal adverse drug reactions for a particular patient.

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Risk factors for recurrence of atrial fibrillation in patients undergoing hybrid therapy for antiarrhythmic drug-induced atrial flutter

European Heart Journal ◽

10.1016/s0195-668x(03)00233-1 ◽

2003 ◽

Vol 24 (13) ◽

pp. 1264-1272 ◽

Cited By ~ 30

Author(s):

C Reithmann

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Atrial Flutter ◽

Antiarrhythmic Drug ◽

Hybrid Therapy ◽

Drug Induced ◽

Risk Factors For Recurrence

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Acute dystonic reaction following treatment with a non-classic neuroleptic of the dibenzazepine-type

Psychiatry and Psychobiology ◽

10.1017/s0767399x00001036 ◽

1987 ◽

Vol 2 (5) ◽

pp. 350-353

Author(s):

E. Scholz ◽

K. Mann ◽

H.W. Schied ◽

M. Bartels

Keyword(s):

Risk Factors ◽

Differential Diagnosis ◽

Cerebral Palsy ◽

Clinical Signs ◽

High Dose ◽

Extrapyramidal Side Effects ◽

Infantile Cerebral Palsy ◽

Drug Induced ◽

Dystonic Reaction ◽

Acute Dystonia

SummaryExtrapyramidal side-effects with drug-induced parkinsonism have not previously been reported following treatment with the atypical dibenzazepine-type neuroleptics, clozapine and fluperlapine. We have however observed reversible acute dystonia in a patient following high-dose fluperlapine treatment. The clinical signs of a discrete infantile cerebral palsy observed in our patient are probably one of the risk factors. Although the differential diagnosis of acute dystonia as opposed to tardive dyskinesia was difficult, the patient's symptoms fit more closely the former. Pharmacological aspects of the observed movement disorder are discussed.

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Anxiety disorders in older people

Reviews in Clinical Gerontology ◽

10.1017/s0959259812000019 ◽

2012 ◽

Vol 22 (3) ◽

pp. 204-217 ◽

Cited By ~ 6

Author(s):

James Lindesay ◽

Robert Stewart ◽

Jatinder Bisla

Keyword(s):

Risk Factors ◽

Older Adults ◽

Differential Diagnosis ◽

Anxiety Disorders ◽

Older People ◽

Age Group ◽

The Past ◽

Treatment And Prevention ◽

Co Morbidity ◽

Assessment Scales

SummaryThis article reviews the research into anxiety disorders in adults aged 65 years and older that has been published over the past ten years. The topics covered include: the construct of anxiety and its disorders in this age group; epidemiology, including prevalence, incidence, course, outlook, and risk factors; assessment scales; co-morbidity and differential diagnosis (depression, dementia, physical illness); and management, both pharmacological and non-pharmacological. There has been a significant improvement in our understanding of these disorders in older adults over this period, but evidence to support their treatment and prevention is still quite sparse.

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