Biomedical subjects

Deborah Wolbrette

Publications and source records attributed to Deborah Wolbrette.

3 recordsLinked to original sources

PubMed2003

Treatment of arrhythmias during pregnancy.

During pregnancy, significant changes occur in the hormonal and hemodynamic state of women that make arrhythmias more likely to occur. Palpitations are frequently reported, but are usually found to be associated with sinus tachycardia. The incidence of paroxysmal supraventricular tachycardia is increased during pregnancy, whereas atrial fibrillation and ventricular tachycardia are rarely seen. Women with long QT syndrome experience significantly more cardiac events in the postpartum period, making beta-blocker therapy most important during this time. Acute treatment of arrhythmias for pregnant women is much the same as that for nonpregnant patients. However, chronic drug therapy during pregnancy should be reserved for only the frequent, hemodynamically significant arrhythmia episodes.

Adrenergic beta-Antagonists↗

PubMed2002

Gender differences in arrhythmias.

Electrocardiographic and electrophysiologic differences between men and women have long been noted. Women have a higher intrinsic heart rate than men, along with a longer corrected QT interval and a shorter sinus nodal recovery time. The incidence of and risk factors for a variety of arrhythmias differ between men and women. Atrioventricular nodal reentry tachycardia has a 2:1 female-to-male predominance, while accessory pathways are twice as frequent in men. Although atrial fibrillation is more prevalent in men of all age groups, the absolute numbers of men and women with atrial fibrillation are equal, and the associated morbidity and mortality experienced by women with atrial fibrillation appear to be worse. Women have a lower incidence of sudden cardiac death, and female survivors of sudden cardiac death have a lower frequency of spontaneous or inducible ventricular tachycardia. On the other hand, drug-induced torsade de pointes and symptomatic long QT syndrome have a female predominance. Therefore, greater caution should be used when prescribing QT-prolonging drugs in women. The incidence of arrhythmias is increased during pregnancy, and management of pregnant patients poses a significant challenge. The mechanisms of these gender differences are unclear but may be related to hormonal effects and the shorter QT interval in adult males. Pharmacologic and nonpharmacologic therapies are usually equally efficacious, but the risks of pharmacologic therapy are different in men and women. Atrial fibrillation may be more difficult to treat in women.

Arrhythmias, Cardiac↗

PubMed2002

Gender differences in the proarrhythmic potential of QT-prolonging drugs.

Female gender is associated with an increased risk of torsades de pointes (TDP) in the setting of drugs that can prolong the QT interval. These drugs are all potassium channel blocking agents and include many frequently used antiarrhythmic drugs, as well as a variety of noncardiac medications. The mechanism of this gender difference is unknown. Some women at risk are silent carriers of the long QT syndrome. The concept of "repolarization reserve" can help predict which individuals are at risk for developing drug-induced TDP. Generic formulations of QT-prolonging drugs have the potential to increase proarrhythmic risk to women. Female subjects need to be well represented in the testing of new potassium channel blocking drugs.

Anti-Arrhythmia Agents↗