Prevention of Torsades de Pointes Using a Clinical Decision Support Tool

Torsades de pointes (TdP) is a rare life threatening heart arrhythmia. It occurs in individuals with genetic mutations in genes that control the expression of ion channel proteins in the heart and is a frequent cause of sudden death in these individuals. TdP also occurs as a complication of drugs that prolong a cardiac timing interval by blockade of potassium channels. This list of drugs includes the antibiotics erythromycin, azithromycin, clarithromycin, levofloxacin and ciprofloxacin. This research is an attempt to make simple, evidence based interventions available for physicians to use, and remind them to use them, when these drugs are prescribed to patients who are at higher risk.

We will use the electronic medical record data to assess the risk of patients who are prescribed these drugs, then identify those at high risk and immediately remind clinicians to take appropriate action. All actions will be those which are commonly identified in the medical literature as decreasing risk. We will constantly monitor this new tool and attempt to make it better and more helpful during the time period of this study.