Genetic basis of drug‐induced arrhythmias

Abstract

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.

• congenital long QT
• pro‐arrhythmia
• torsade de pointes