title: Significance of screening electrocardiogram before the initiation of amitriptyline therapy in children with functional abdominal pain.
abstract: Amitriptyline (AMT) is commonly used in the management of children with irritable bowel syndrome. AMT is pro-arrhythmogenic and increases the risk of sudden cardiac death. However, there is not enough data regarding the cardiac toxicity in therapeutic doses of AMT in children and the need for screening electrocardiogram (EKG). Errors in computer EKG interpretation are not uncommon. In a risk-prevention study, the authors sought to identify the true incidence of prolonged corrected QT (QTc) interval and other arrhythmias in children with irritable bowel syndrome before the initiation of AMT. Out of the 760 EKGs screened, 3 EKGs demonstrated a true prolonged QTc after the careful manual reading by a pediatric cardiologist and they were not picked by computer-generated reading. The authors conclude that screening EKG should always be performed on children before initiating AMT therapy. Also, the computer-generated EKG needs to be verified by a pediatric cardiologist to avoid serious misinterpretations.
authors.affiliation: Louisiana State University, Shreveport, LA 71118, USA.
authors.forename: Kamakshya P
authors.initials: KP
authors.lastname: Patra
authors.forename: Senthilkumar
authors.initials: S
authors.lastname: Sankararaman
authors.forename: Robert
authors.initials: R
authors.lastname: Jackson
authors.forename: Sunny Z
authors.initials: SZ
authors.lastname: Hussain
mesh_terms: D015746:Abdominal Pain / Q000188:drug therapy / Q000209:etiology; D000293:Adolescent; D000639:Amitriptyline / Q000009:adverse effects* / Q000627:therapeutic use; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects* / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000139:chemically induced / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D004334:Drug Administration Schedule; D004562:Electrocardiography / Q000379:methods; D006801:Humans; D015994:Incidence; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000188:drug therapy*; D018570:Risk Assessment; D012815:Signal Processing, Computer-Assisted
chemical_list: D018712:Analgesics, Non-Narcotic; D000639:Amitriptyline