Dysrhythmic profile of human immunodeficiency virus infected patients

Cardoso, Jaime S.; Mota-Miranda, A.; Cruz, Alda Maria da; Gomes, Maria Helena; Oliveira, Pedro; Rocha-Gonçalves, Francisco; Lecour, Henrique

doi:10.1016/0167-5273(95)02313-l

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…Therefore, as described in prior studies, Efavirenz may not contribute to an increased rate of blocks and other conduction disturbances in HIV-infected patients. [36][37][38] Despite general similarity of the two groups at baseline, a higher proportion of non-Efavirenz patients received PI. Treatment with PIs was not associated with dysrhythmia or significant ECG changes.…”

Section: Discussionmentioning

confidence: 99%

Association between exposure to Efavirenz and substrates of dysrhythmia in HIV‐infected young adults

Hosseini

Mollazadeh

Dehghan-Manshadi

et al. 2021

Clinical Cardiology

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Background: Dysrhythmia and sudden cardiac arrest occur more likely in HIV patients than healthy subjects. Thus, we need to examine dysrhythmias adverse effects of medications including Efavirenz as early as possible especially in young subjects.Hypothesis: Efavirenz might have contributed to increased risk of developing common types of dysrhythmia in young HIV infected patients.Methods: We performed a retrospective cohort study among 62 patients on Efavirenz and 38 controls. All participants were under 40 years old without cardiovascular disease. Total significant dysrhythmia in 24-hour ECG monitoring was the primary endpoint determined as the composite of high premature ventricular contraction (PVC) (>500 beats per 24 hours), high premature atrial contraction (PAC) (>500 bp24h), sinus pause, atrioventricular blocks, ventricular tachycardia, prolonged QTc, and low heart rate variability (HRV). Modified composite dysrhythmia consisted of low HRV (SD of normal-to-normal [SDNN]), high PVC and prolonged QT.Results: Mean heart rate, Efavirenz regimen, male gender, and CD4 count predicted total dysrhythmia. Odds ratios were 1.108, 2.90, 4.36, and 0.96, respectively. The incidence of total dysrhythmia, high PVC, high PAC, low HRV(SDNN), and prolonged QTc were 54.8%, 41.85%, 9.71%, 45.2%, and 12.9% in patients on Efavirenz against 42.11%, 31.64%, 0%, 34.2%, and 7.91% in controls, respectively (p-values: .031, .001, <.0001, .063, and .043 respectively). Modified composite dysrhythmia was also more frequent in Efavirenz group than that of control group (69.42% vs. 52.60%, respectively p = .032).

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Section: Discussionmentioning

confidence: 99%

Association between exposure to Efavirenz and substrates of dysrhythmia in HIV‐infected young adults

Hosseini

Mollazadeh

Dehghan-Manshadi

et al. 2021

Clinical Cardiology

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“…Besides, a 24-hour Holter monitoring study in 21 HIV-infected patientsr evealed an unexpectedly high incidence of conduction disturbances: one patient (4.8%) with intermittent Mobitz type I second degree AV block, two patients (9.5%) with paroxistic 2:1 AV block and one patient (4.8%) with a bifascicular block [10]. Electrocardiogramm abnormalities including new onset atrioventricular block and bundle branch block resulted in premature termination of a study of concurrent atazanavir-and lopinavir/ritonavir-treatment in HIV patients with extensive antiretroviral resistance [11].…”

Section: Figurementioning

confidence: 99%

Diagnostic ergometry in an HIV-positive patient with effort dyspnea

2010

Cardiovasc Med

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A case of a 40-year-old patient with known HIV-infection and new onset of exertional dyspnea with dizziness is presented. At the end of an extensive diagnostic investigation, the underlying exercise-induced second degree 3:1 atrioventricular (AV) block was revealed by means of an ergometry/bicycle stress test. After exclusion of reversible causes, a DDD pacemaker was implanted three months after the onset of symptoms. Thereafter, the patient was free from her complaints, but progressed to third degree AV block in the second year of follow-up. Figure 1Resting ECG: Sinus bradycardia 44 bpm, but no ischaemia.

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“…In literature, the association among ventricular arrhythmia, VLP and variations of the heart rate (HR) has been demonstrated by techniques of signal-averaging electrocardiography (SAECG), in which pharmacological and clinical experiments have been conducted [7,8]. These works suggest that cardiac beat inside a certain range of variation of the HR are associated with an increased prevalence of VLP and, therefore, a possible elevation of the risk for RVA.…”

Section: Introductionmentioning

confidence: 97%

Assessment of ventricular late potentials in HIV positive patients based on the RR interval histogram

Benchimol-Barbosa

Barbosa-Filho²,

De-Sa³

et al.

Computers in Cardiology 1999. Vol.26 (Cat. No.99CH37004)

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Ventricular late potentials (VLP) are fiagmented electrical activities, originated fiom regions with delayed conduction in the damaged myocardium, and markers of ventricular arrhythmia due to reentry. Individuals infected by the human immunodeficiency virus (HIV) present an elevated risk of sudden death, fiom a mechanism not yet filly understood. The high prevalence of VLP in the signal-averaged ECG of these patients reinforces a possible arrhythmic mechanism and may be of prognostic signijkance. This paper investigates the prevalence of VLP in 34 HIV positive patients, CDC classes II and IV during ambulatov evaluation. The results demonstrate that VLP are highly correlated with the instantaneous heart rate, specially in patients with clinical manifestation of immunodeficiency, and suggests that heart rate variability may influence variations in VLP duration.

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Dysrhythmic profile of human immunodeficiency virus infected patients

Cited by 5 publications

References 18 publications

Association between exposure to Efavirenz and substrates of dysrhythmia in HIV‐infected young adults

Association between exposure to Efavirenz and substrates of dysrhythmia in HIV‐infected young adults

Diagnostic ergometry in an HIV-positive patient with effort dyspnea

Assessment of ventricular late potentials in HIV positive patients based on the RR interval histogram

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