Related Links
Statistics
| Number of Journals | 8 |
| Number of Issues | 59 |
| Number of Articles | 440 |
| Article View | 160,605 |
| PDF Download | 105,437 |
Evaluating the incidence of syncope and electrocardiogram changes in methadone-treated volunteers quitting addiction in yazd | ||
| Cardiovascular Biomedicine | ||
| Article 6, Volume 4, Issue 2, December 2024, Pages 38-43 PDF (580.82 K) | ||
| Document Type: original articles | ||
| DOI: 10.18502/cbj.v4i2.17794 | ||
| Authors | ||
| Hesam Hosseini1; Mehdi Amirheydary2; Mohammad Taghi Sarebanhassanabadi3; Mohammad Poorebrahimi3; Roya Soleimani Veirani1; Seyed Mostafa Seyed Hossaini Tezerjani* 3 | ||
| 1Department of Cardiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran | ||
| 2Addiction Treatment Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran | ||
| 3Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran | ||
| Abstract | ||
| Objectives: Methadone is a synthetic opioid with a high affinity for opioid receptors, widely used as an effective intervention for opioid dependence and the management of acute and chronic pain. However, its use has been associated with serious cardiac side effects, including torsades de pointes (TdP) and prolonged QTc intervals. This study investigated the incidence of syncope and electrocardiogram (ECG) changes in individuals who underwent methadone treatment for addiction. Methods: This cross-sectional study, conducted in Yazd in 2020, involved 100 participants seeking methadone treatment at an addiction clinic. A cardiologist recorded initial ECGs using a 12-lead ECG device, assessing parameters such as heart rhythm, QTc interval, and premature contractions. Participants were informed about the study procedures and the necessity of follow-up ECGs one week and three months after starting methadone. The researchers monitored the patients for three months with regular outpatient visits. Results: The findings revealed a significant difference in syncope incidence based on ECG rhythm on day seven and month three, with higher rates observed in patients exhibiting junctional rhythms or PVC (p-value=0.000). Additionally, a significant relationship was found between syncope frequency and U wave status at month three (p-value=0.046). No significant associations were noted for ST segment changes or T wave variations. Furthermore, higher methadone doses, longer QTc intervals on day seven, and prolonged PR intervals correlated with increased syncope occurrences. Conclusions: This study indicates that ECG-related variables and methadone dosage significantly influence syncope incidence among treated patients. Specifically, individuals with junctional rhythms or PVC and those receiving higher doses of methadone were at greater risk for syncope. Monitoring PR and QTc intervals is crucial for preventing syncope in patients undergoing methadone treatment. | ||
| Keywords | ||
| Methadone; Syncope; Electrocardiography; Opioid-Related Disorders; Iran | ||
| References | ||
|
1.Hyland SJ, Brockhaus KK, Vincent WR, et al. Perioperative pain management and opioid stewardship: a practical guide. Healthcare. 2021;9(3):333.
2.Blad H, Lamberts RJ, van Dijk GJ, et al. Tilt-induced vasovagal syncope and psychogenic pseudosyncope: Overlapping clinical entities. Neurology. 2015;85(23): 2006-10.
3.Sutton R, Benditt DG. Epidemiology and economic impact of cardiac syncope in western countries. Future Cardiol. 2012;8(3):467-72.
4.Ferreira LA, Aoki CT, Santos DC, et al. Antinociceptive synergism upon the joint use of methadone and Phα1β in a model of cancer-related pain in C57BL/6J mice. Life Sci. 2021;278:119582.
5.Salas WE, Cortinez LI, López RA, et al. Pharmacokinetics of Methadone in Adult Patients Undergoing Cardiac Surgery With Cardiopulmonary Bypass. Anesthesia & Analgesia. 2022:10-213.
6.Ruwald MH, Hansen ML, Lamberts M, et al. The relation between age, sex, comorbidity, and pharmacotherapy and the risk of syncope: a Danish nationwide study. Europace. 2012;14(10):1506-14.
7.Mahu IT, Barrett SP, Conrod PJ, et al. Different drugs come with different motives: Examining motives for substance use among people who engage in polysubstance use undergoing methadone maintenance therapy (MMT). Drug Alcohol Depend. 2021;229(Pt B):109133.
8.MacNeill L, Brunelle C, DiTommaso E, et al. Client characteristics and substance use patterns in different models of methadone maintenance therapy (MMT). J Substance Use. 2020;25(4):377-81.
9.Lieve KV, van der Werf C, Wilde AA. Catecholaminergic Polymorphic Ventricular Tachycardia. Circ J. 2016;80(6):1285-91.
10.Shen WK, Sheldon RS, Benditt DG, et al. 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2017;136(5):e60-e122.
11.Taheri SK, Bawand R, Sanginabadi F, et al. One-year survey of methadone-induced Cardiac complications. Caspian J Intern Med. 2023;14(1):43-46.
12.Komatsu R, Nash MG, Wu J, et al. Prediction of postoperative respiratory depression and respiratory complications in patients on preoperative methadone. J Anesth. 2023;37(1):79-91.
13.Moya A, Sutton R, Ammirati F, et al. Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J. 2009;30(21):2631-71.
14.Maron BJ, Rowin EJ, Casey SA, et al. How Hypertrophic Cardiomyopathy Became a Contemporary Treatable Genetic Disease With Low Mortality: Shaped by 50 Years of Clinical Research and Practice. JAMA Cardiol. 2016;1(1):98-105.
15.Calkins H. Arrhythmogenic right ventricular dysplasia/cardiomyopathy-three decades of progress. Circ J. 2015;79(5):901-13.
16.Mizusawa Y, Wilde AA. Brugada syndrome. Circ Arrhythm Electrophysiol. 2015;5 (3):606-16.
17.Napolitano C, Bloise R, Monteforte N, et al. Sudden cardiac death and genetic ion channelopathies: long QT, Brugada, short QT, catecholaminergic polymorphic ventricular tachycardia, and idiopathic ventricular fibrillation. Circulation. 2012;125 (16):2027-34.
18.Sheldon R. How to Differentiate Syncope from Seizure. Cardiol Clin. 2015;33(3): 377-85.
19.Chisholm P, Anpalahan M. Orthostatic hypotension: pathophysiology, assessment, treatment and the paradox of supine hypertension. Intern Med J. 2017;47(4):370-379.
20.Sheldon RS, Grubb BP 2nd, Olshansky B, et al. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12(6):e41-63.
21.Solbiati M, Costantino G, Casazza G, et al. Implantable loop recorder versus conventional diagnostic workup for unexplained recurrent syncope. Cochrane Database Syst Rev.2016;4(4):CD011637.
22.Shakouri H, Zerehsaz MJ, Farajipour S, et al. Effect of Methadone therapy on QTc interval in electrocardiogram of opioid addicted patients. J Gorgan Uni Med Sci.2014;16(3):45-8.
23.Keller K, Beule J, Balzer JO, et al. Syncope and collapse in acute pulmonary embolism. Am J Emerg Med. 2016;34(7):1251-7.
24.Bonakdaran S, Akbari Rad M, Hasanzadeh Deloie M, et al. QTc prolongation in methadone users and its relation with hormonal changes. MJMS MUMS. 2017;60(2): 441-9.
25.Hydrochloride C. The American Society of Health-System Pharmacists. Archived from the original on June. 2015;30.
26.Mayet S, Gossop M, Lintzeris N, et al. Methadone maintenance, QTc and torsade de pointes: who needs an electrocardiogram and what is the prevalence of QTc prolongation? Drug Alcohol Rev. 2011;30(4):388-96.
27.Fonseca F, Marti-Almor J, Pastor A, et al. Prevalence of long QTc interval in methadone maintenance patients. Drug Alcohol Depend. 2009;99(1-3):327-32.
28.Brigo F, Nardone R, Bongiovanni LG. Value of tongue biting in the differential diagnosis between epileptic seizures and syncope. Seizure. 2012;21(8):568-72. | ||
|
Statistics Article View: 227 PDF Download: 158 |
||