Table 3.
Further information to be requested
| Event history |
| Acute ischaemia (yes/no) |
| Acute reversion of AF (within 48 h of event) |
| Acute intracerebral event |
| Serum K, Mg, and Ca prior to and after the eventa |
| Acute therapy |
| Defibrillation |
| Temporary pacing |
| Electrolyte replacement |
| Beta-blockers |
| Other medications |
| Other |
| Long-term therapy |
| Permanent pacemaker |
| ICD |
| Other |
| ECG findings |
| After exposure to culpable drug fully removed (consistent with pharmacology of drug) |
| QRS, QT, RR, QTcB |
| Digital 24 h Holter monitor if available |
| Other findings: atrial fibrillation, heart block |
| Laboratory findings |
| Renal function parametersa |
| Liver function parametersa |
| Thyroid statusa |
| Past cardiac history |
| LV ejection fraction and hypertrophya |
| Type/extent of heart diseasea |
| Congenital long QT syndrome (mutation if known) |
| Presence of AF, last known AFa |
| Presence of paced rhythm |
| Past medical history |
| Diabetes |
| Hypothyroidism |
| Liver disease |
| Psychiatric disease |
| Family history |
| Congenital long QT syndrome |
| Sudden death age <age 45 |
| Sudden death >age 45 |
| Other heart disease |
| Patient characteristics |
| BMI |
aWith dates/times.