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Comment & Response
April 2016

Drug-Induced Torsades de Pointes and Genetic Screening—Reply

Author Affiliations
  • 1Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas
  • 2Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas
JAMA Intern Med. 2016;176(4):561. doi:10.1001/jamainternmed.2016.0076

In Reply We would like to thank Dr Noheria for his interest in our article.1 Genetic susceptibility is an important consideration in patients with drug-induced Torsades de Pointes (TdP) because it may be the sentinel event unmasking an underlying congenital long QT syndrome (LQTS). Previous studies have identified congenital LQTS in 5% to 20% of cases with drug-induced TdP.2,3 We agree that genetic testing for congenital LQTS in patients with drug-induced TdP and first-degree family members has important prognostic and therapeutic implications. A decision to pursue genetic testing in such a patient requires individualized consideration and should be preceded by a careful review of the patient’s personal history and family history. Furthermore, the test results must be interpreted and communicated with caution owing to the probabilistic nature of all genetic tests.4

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