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Table 2 Classification of 35 patients with fatal outcome from cardiac origin presumably related to halofantrine (HF) according to the number of predisposing factors to cardiac complication and indication for halofantrine

From: Fatal cardiotoxicity related to halofantrine: a review based on a worldwide safety data base

Number of predisposing factor(s), number of patients (number of children)

Details on predisposing factors (underlying cardiac disease, concomitant medication, misuse of HF, etc)

Wrong or debatable indication for HF

no predisposing factors, n = 9 (0)

Pt # 2, 11§ 12, 16, 17, 18, 20, 31, 33

a* = 1, b* = 2, c* = 1, d* = 2

1 predisposing factor, n = 16 (2)

Pt # 1, 30: vibramycine

b* = 3, c* = 2

 

Pt # 5, 8, 14, 19: chloroquine

e* = 1

 

Pt # 7: bundle branch block¤

 
 

Pt # 9, 34: HF taken with food

 
 

Pt # 13: metronidazole

 
 

Pt # 21: potassium infusion

 
 

Pt # 23: unknown severe cardiac valve disease

 
 

Pt # 24: angina pectoris

 
 

Pt # 25: ciprofloxacine

 
 

Pt # 29: mefloquine

 
 

Pt # 32: HF overdose (45 mg/kg)

 

2 predisposing factors, n = 5 (2)

Pt # 3: cardiomyopathy¤ + furosemide

a* = 1; c* = 1

 

Pt # 4: obesity + chloroquine

d* = 1; f* = 1

 

Pt # 6: tachycardia + mefloquine

 
 

Pt # 10: severe anaemia and dehydration + amodiaquine

 
 

Pt # 26: unknown right ventricular arrhythmogenic dysplasia + chloroquine

 

3 predisposing factors, n = 5 (1)

Pt # 15: cardiac arrhythmia + chloroquine + amodiaquine

b*= 2; c* = 2

 

Pt # 22: arteriosclerosis and high blood pressure + indapamide + HF taken with food

 
 

Pt # 27: unknown cardiomyopathy + mefloquine + erythromycin

 
 

Pt # 28: unknown right ventricular arrhythmogenic dysplasia + chloroquine + probable HF overdose°

 
 

Pt # 35: tachyarrhythmia¤ + mefloquine + HF overdose (72 mg/kg)

 
  1. *: a = no certainty of malaria diagnosis/no blood smear performed (industrialised country);
  2. b = no certainty of malaria diagnosis/no blood smear performed (developing country);
  3. c = no malaria (blood smear negative); d = possible severe malaria; e = severe malaria;
  4. f = P. vivax
  5. ¤: known prior to HF prescription; §actual exposure to HF unsure; ° high HF blood level (see text)