Estimates of population-based incidence of malignant arrhythmias associated with medication use-a narrative review.

Certain medications are reported to be associated with acquired long-QT syndrome (ALQTS), which can degenerate into a potentially severe 'malignant' arrhythmia known as torsades de pointes (TdP). However, population-based estimations of the incidence of medication-associated malignant arrhythmia are limited. The purpose of this article is to review the clinical symptoms, cellular mechanism, categorization, and risk factors of these malignant arrhythmias, as well as illustrate results and methodological limitations of epidemiological literature which have previously estimated population-based incidence of ALQTS and malignant arrhythmia. Administrative databases in universal healthcare systems (such as Canada) can be used to provide a robust estimate of this incidence. We present a valid operational definition of medication-associated malignant arrhythmia, using Canadian hospital administrative data linked to prescription databases that can be used to estimate the population-based incidence. An estimation of incidence may have important implications with regard to understanding the potential widespread distribution of this adverse effect-which may influence medication prescribing patterns.