open access

Vol 15, No 6 (2008)
Review articles
Published online: 2008-09-22
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Drug-induced QRS morphology and duration changes

John E. Madias
Cardiol J 2008;15(6):505-509.

open access

Vol 15, No 6 (2008)
Review articles
Published online: 2008-09-22

Abstract

Drug-induced ECG changes may affect all components of the ECG curve. The attention of regulatory agencies, researchers and clinicians has been directed towards drug-induced QT-interval prolongation and its well-documented proarrhythmia. This presentation focuses on druginduced changes, i.e., morphology, amplitude and QRS complex duration (QRSd). A great variety of pharmacological agents (e.g., class IA and IC antiarrhythmics, antihistamines, antidepressants, antipsychotics) exert an influence on the QRSd. The QRSd is assessed by a variety of ECG methodologies. Standardization of measurements of QRSd ensures the comparability of results by different ECG modalities, and of serial QRSd assessments. Some analgesics and hypoglycemic agents influence the amplitude of QRS complexes by way of their propensity to cause peripheral oedema (extracardiac mechanism). Perhaps a new culture could evolve in which the entire ECG curve, from the onset of the P-wave to the offset of the U-wave, will be used in the evaluation and monitoring of drug safety, with emphasis primarily on the standard ECG.

Abstract

Drug-induced ECG changes may affect all components of the ECG curve. The attention of regulatory agencies, researchers and clinicians has been directed towards drug-induced QT-interval prolongation and its well-documented proarrhythmia. This presentation focuses on druginduced changes, i.e., morphology, amplitude and QRS complex duration (QRSd). A great variety of pharmacological agents (e.g., class IA and IC antiarrhythmics, antihistamines, antidepressants, antipsychotics) exert an influence on the QRSd. The QRSd is assessed by a variety of ECG methodologies. Standardization of measurements of QRSd ensures the comparability of results by different ECG modalities, and of serial QRSd assessments. Some analgesics and hypoglycemic agents influence the amplitude of QRS complexes by way of their propensity to cause peripheral oedema (extracardiac mechanism). Perhaps a new culture could evolve in which the entire ECG curve, from the onset of the P-wave to the offset of the U-wave, will be used in the evaluation and monitoring of drug safety, with emphasis primarily on the standard ECG.
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Keywords

ECG; QRS duration; drug-induced ECG changes; drug-induced QRS duration changes; drug-induced QRS morphology changes; drug-induced QRS amplitude changes

About this article
Title

Drug-induced QRS morphology and duration changes

Journal

Cardiology Journal

Issue

Vol 15, No 6 (2008)

Pages

505-509

Published online

2008-09-22

Bibliographic record

Cardiol J 2008;15(6):505-509.

Keywords

ECG
QRS duration
drug-induced ECG changes
drug-induced QRS duration changes
drug-induced QRS morphology changes
drug-induced QRS amplitude changes

Authors

John E. Madias

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