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Comment & Response |

Drug-Induced Torsades de Pointes and Genetic Screening—Reply

Arjun Gupta, MD1; Ambarish Pandey, MD2
[+] 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.
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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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April 1, 2016
Amit Noheria, MBBS, SM
1Cardiovascular Division, Washington University School of Medicine, St Louis, Missouri
JAMA Intern Med. 2016;176(4):560-561. doi:10.1001/jamainternmed.2016.0070.
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